Do the WHO's "best buys" work?
By Kristof Redei @ 2025-12-01T20:54 (+11)
This is a linkpost to https://snowdon.substack.com/p/do-the-whos-best-buys-work
A provocative post from Christopher Snowdon's Substack on whether the World Health Organization's list of "best buy" policies on alcohol - taxation, advertising restrictions, and availability constraints - pass the cost-effectiveness standard they set for themselves: averting the loss of a Disability-Adjusted Life Year for less than $100 in a low or lower-middle-income country and less than $500 in a rich country.
As a member of a free market think tank, the author likely opposes these policies on grounds other than cost-effectiveness, but he does a good job of steelmanning the case for them while providing substantial evidence for his conclusion that the answer is a fairly straightforward "no":
If reducing alcohol consumption (and, it is therefore assumed, alcohol-related harm) is the goal, the ‘best buys’ are neither a sufficient nor a necessary way to do it. Even advocates of such interventions admit that “reducing price and increasing availability does not always increase alcohol consumption and harm. Effects are dampened in affluent societies, and other factors may intervene”.
Worth a read for anyone interested in alcohol policy or the regulation of and reduction of harm from psychoactive substances more generally.
Rasool @ 2025-12-04T05:59 (+7)
I expect there is some variability, the author in this piece focuses on alcohol, which I don't know that much about, but for "Reduce unhealthy diet" (Objective 3, page 10), CEARCH did a report here, which relates to WHO's best buys (if not quite exactly matching their specified intervention), and found it to be "49,419 DALYs per USD 100,000"
For best buys in education, I recommend Rachel Glennester's 80,000 hours podcast episode, where she praises the best buys, but also criticises how education spending is done
She has a second episode, which also touches on best buys
P.S. I'm not sure why this post has two disagree votes - seems like a perfectly valid forum post to me
Joel Tan🔸 @ 2025-12-13T03:04 (+4)
There's very strong empirical evidence that taxes reduce alcohol consumption (price elasticity is about -0.5, so a 10% increase in price reduces consumption by 5%), and the evidence that alcohol harms health is well-established enough that I won't belabour the point
It's probably also cost-effective. Rough rule of thumb is that policy interventions are highly cost-effective due to large scale of impact (policy has national level reach, while is hard to beat), and low cost per capita (particularly due to leveraging less impactful government spending). GiveWell estimates that alcohol policy may be more cost-effective than its top charities, and Charity Entrepreneurship estimates that it's potentially competitive with GiveWell top charities. Uncertainty is very high, of course.
The other posters have also rightly pointed out the conflict-of-interest reasons you should distrust this Snowdon fellow, but also the fact of the matter is that the scientific consensus is what it is for a reason, and even without conflict-of-interest reasons you shouldn't put too much stock in what some rando says over what experts as a whole say.
Mihkel Viires 🔹 @ 2025-12-04T10:52 (+3)
FYI, the Institute of Economic Affairs, where Snowdon works, is known to have received funding from alcohol, tobacco, sugar, gambling, and oil industry lobbies.[1] The UK's Charity Commission recently opened an investigation into IEA.[2]
Jason @ 2025-12-04T13:38 (+3)
This is particularly relevant because the reader is dependent on trusting Snowdon to have conducted a balanced review of the literature. I was already skeptical that he had done so even before considering that he has an ideological axe to grind and now a potential financial conflict of interest.
The article has value; it reminds us that local context matters and that we should exercise caution in blindly applying a general finding to specific circumstances. But it would have been a lot stronger if it had grappled with the arguments and evidence that led WHO to deem these interventions best buys, and had acknowledged the limited scope of his own data analysis more.