Gates has more money than he knows what to do with. If he wants to spend another hundred billion, he could just donate it himself. He doesn't have quite as much money outside the foundation as Buffet, but almost. Donating to Gates has zero value. Maybe spending on militias has negative value, but so do most of these foundations.
Donating to Gates was a bad idea 20 years ago. Maybe there was some option value that he would think of a way to spend the money, but he didn't. Gates should have tried to convince Buffet to donate not his money but his time, his expertise in management. Maybe he tried, but he failed 20 years ago and today changes nothing.
There’s no good reason to think that GiveWell’s top charities are net harmful.
Blanket deworming is a Pascal wager. GiveWell's assessment is that the small number of studies are probably wrong, but the claimed effect is so big that it's worth trying. Net of this zero effect, you must subtract the cost: drugs so awful they cause riots. GiveWell does not attempt to measure this cost. Maybe you accept the gamble, but this item seems worded to avoid that framing. Or maybe you drop the huge income effects and retreat to the health effects. How many children should you poison to cure one of parasites? GiveWell does not say.
You should be suspicious of the reality of the income effect because it is so much larger than the health effect. The really bad hypothesis is that the income effect is real, but unrelated to health (alt link).
I think this was wrong. I don't know where I heard the story about Clinton negotiating price discrimination, but, actually, generics already existed in 2001 before either PEPFAR or Clinton started buying. PEPFAR simply refused to use them because it wasn't actually about saving lives. It switched in 2006 because it was embarrassed by Clinton and WHO using them.
Oster seemed to be aware that PEPFAR was paying 10x as much as WHO, as she writes "Even at generic drug prices." It is a travesty that she didn't draw attention to this.
PEPFAR wasn't a humanitarian program, but a giveaway to drug companies. It is good that humanitarians stole the money and gave it to public health, but that's no credit to the people who pretended to do charity in the first place. And the cost effectiveness of the project of entering government and stealing money has to be judged by all the people who tried and failed, not just by one project. If this were a real public health project, it would be good to hold it up to tell the other public health projects to be more like it, but it was a sham and telling the other shams to be more like it is unlikely to be effective.
Does anyone care that FTX failed? They care that it stole. A complete fraud like Theranos only destroyed a billion dollars of investor money. Whereas a bank like FTX has access not only to investor money, but also to much more money in the form of deposits from people who don't think they're making an investment in a risky start up.