Global health is important for the epistemic foundations of EA, even for longtermists

Perhaps related:

 It took until 2010 or so for effective altruism to become a movement, even though there's not a lot of distance between EA and Peter Singer's early writings. I believe that Givewell was a  crucial ingredient here. 

On my model, people being able to rally around concrete charities wasn't just a forceful example to use against common objections. Perhaps more importantly, Givewell made doing good tractable enough for young university students so they could achieve easy successes, which probably reinforced the self-image of those aspiring altruists. Absent some tractable ways to do good, people might lose the motivation to devote their careers to EA causes or, more generally, stay passive consumers of discussion material, never becoming personally "activated." 


 

I agree with this, but a meta comment. I’m sort of feeling uncomfortable with how much of the defence of EA funding global health is phrased in indirect terms rather than defending the object level value itself:

E.g.,

• it’s a good testing ground, has good feedback loops
• has good optics
• keeps us grounded

Etc.

This is great and I’m glad you wrote it. For what it’s worth, the evidence from global health does not appear to me strong enough to justify high credence (>90%) in the claim “some ways of doing good are much better than others” (maybe operationalized as "the top 1% of charities are >50x more cost-effective than the median", but I  made up these numbers).

The DCP2 (2006) data (cited by Ord, 2013) gives the distribution of the cost-effectiveness of global health interventions. This is not the distribution of the cost-effectiveness of possible donations you can make. The data tells us that treatment of Kaposi Sarcoma is much less cost-effective than antiretroviral therapy in terms of avoiding HIV related DALYs, but it tell us nothing about the distribution of charities, and therefore does not actually answer the relevant question: of the options available to me, how much better are the best than the others?

If there is one charity focused on each of the health interventions in the DCP2 (and they are roughly equally good at turning money into the interventions) – and therefore one action corresponding to each intervention – then it is true that the very best ways of doing good available to me are better than average.

The other extreme is that the most cost-effective interventions were funded first (or people only set up charities to do the most cost-effective interventions) and therefore the best opportunities still available are very close to average cost-effectiveness. I expect we live somewhere between these two extremes, and there are more charities set up for antiretroviral therapy than kaposi sarcoma.

The evidence that would change my mind is if somebody publicly analyzed the cost-effectiveness of all (or many) charities focused on global health interventions. I have been meaning to look into this, but haven’t yet gotten around to it. It’s a great opportunity for the Red Teaming Contest, and others should try to do this before me. My sense is that GiveWell has done some of this but only publishes the analysis for their recommended charities; and probably they already look at charities they expect to be better than average – so they wouldn’t have a representative data set.

even if we’re coming from a position that thinks they’re not the most effective causes 

How do you interpret "most effective cause"? Is it "most effective given the current funding landscape"?

This seems mostly right, but it still doesn't seem like the main reason that we ought to talk about global health.

There are lots of investors visibly trying to do things that we ought to expect will make the stock market more efficient. There are still big differences between companies in returns on R&D or returns on capital expenditures. Those returns go mainly to people who can found a Moderna or Tesla, not to ordinary investors.

There are not (yet?) many philanthropists who try to make the altruistic market more efficient. But even if there were, there'd be big differences in who can accomplish what kinds of philanthropy.

Introductory EA materials ought to reflect that: instead of one strategy being optimal for everyone who wants to be an EA, the average person ought to focus on easy-to-evaluate philanthropy such as global health. A much smaller fraction of the population with unusual skills ought to focus on existential risks, much as a small fraction of the population ought to focus on founding companies like Moderna and Tesla.

Thank you for contributing this. I enjoyed reading it and thought that it made some people’s tendency in EA (which I might be imagining) to "look at other cause-areas with Global Health goggles" more explicit.

Here are some notes I’ve taken to try to put everything you’ve said together. Please update me if what I’ve written here omits certain things, or presents things inadequately. I’ve also included additional remarks to some of these things.

• Central Idea: [EA’s claim that some pathways to good are much better than others] is not obvious, but widely believed (why?).
  • Idea Support 1: The expected goodness of available actions in the altruistic market differs (across several orders of magnitude) based on the state of the world, which changes over time.
    • If the altruistic market was made efficient (which EA might achieve), then the available actions with the highest expected goodness, which change with the changing state of the world, would routinely be located in any  world state. Some things don't generalize.
  • Idea Support 2: Hindsight bias routinely warps our understanding of which investments, decisions, or beliefs were best made at the time, by having us believe that the best actions were more predictable than they were in actuality. It is plausible that this generalizes to altruism. As such, we run the risk of being overconfident that, despite the changing state of the world, the actions with the highest expected goodness presently will still be the actions with the highest expected goodness in the future, be that the long-term one or the near-term one.
  • (why?): The cause-area of global health has well defined metrics of goodness, i.e. the subset of the altruistic market that deals with altruism in global health is likely close to being efficient.
    • Idea Support 3: There is little cause to suspect that since altruism within global health is likely close to being efficient, altruism within other cause-areas are close to efficient or can even be made efficient, given their domain-specific uncertainties.
  • Idea Support 4: How well “it’s possible to do a lot of good with a relatively small expenditure of resources” generalizes beyond global health is unclear, and should likely not be a standard belief for other cause-areas. The expected goodness of actions in global health is contingent upon the present world state, which will change (as altruism in global health progresses and becomes more efficient, there will be diminishing returns in the expected goodness of the actions we take today to further global health)
  • Action Update 1: Given the altruistic efficiency and clarity within global health, and given people’s support for it, it makes sense to introduce EA’s altruist market in global health to newcomers; however, we should not “trick” them into thinking EA is solely or mostly about altruism in global heath - rather, we should frame EA’s altruist market in global health as an example of what a market likely close to being efficient can look like.

Thanks for writing this! The fact that it highlights a premise in EA ("some ways of doing good are much better than others")  that a lot of people (myself included) take without very careful consideration makes me happy that it's been written. 

Having said that, I am not sure that I believe this more generally because of the reasoning that you give:  “well if it’s true even there [in global health] where we can measure carefully, it’s probably more true in the general case”. I think this is part of my belief, but the other part is that just directly comparing the naive expected value of interventions in different cause areas makes this seem true. 

For example, under some views of comparing animal welfare to humans, it seems far more impactful to donate to cage-free hen corporate outreach campaigns which per dollar, affects between 9 and 120 years of chicken life, compared to AMF. Further, my impression is that considering the expected value of longtermist interventions also would represent quite a large difference. 

This is partially why I try to advocate for members of my group to develop their own cause-prioritization. 

Another advantage from global poverty and health projects is demonstrating clearly the multiplier effect of donations.  The base case is a cash transfer to a person with one hundredth of the donor’s income, which should give a one hundred times boost to welfare.  From this compelling starting point we can then proceed to argue why in expectation other projects may do even better.  We can picture a range of projects from those with good evidence base but returns only a modest multiple above cash transfers (bed nets) to project which could produce higher returns but have limited evidence (charity start ups).  Doners may want to fund along this continuum.

The definition of health here should include mental and socioemotional health, since they affect how people reason and relate to each other, respectively.