Has anything in the EA global health sphere changed since the critiques of "randomista development" 1-2 years ago?

By Max Görlitz @ 2021-12-02T12:14 (+51)

Just recently I re-discovered posts from 1-2 years ago which discussed critiques of the GiveWell style approach to global health, namely the focus on RCTs.

For example, Ben Kuhn's article suggested that maybe we should look more at the cost-effectiveness of political change. Then there is the wildly popular post on growth and randomista development, which suggested that maybe we should pay more attention to economic growth interventions. 

I am sure these articles sparked lots of discussion in the GiveWell and EA global health community. My question is: Has anything changed since then? Has anyone put more resources into researching these topics? How has the thinking of EA global health people developed? 


Jackson Wagner @ 2021-12-02T21:38 (+22)

(Written as an "answer" rather than a "comment" but nevertheless all the below is just my own personal opinion.)

I had a similar reaction when I recently came across the "Growth vs Randomista Development" post, and I think that EA is probably making a mistake by not focusing more on the "medium-termist" cause area of economic growth interventions. I think there are several understandable reasons why this has happened:

Most importantly, I think economic growth interventions fall into a gap between longtermism and near-termism. People who want to know for certain that their money/efforts are helping people today at a guaranteed high level of effectiveness, can use Givewell top charities. Economic interventions work less well because "lobbying" approaches are much more indirect and ascribing causality is hard, plus lobbying for political change to economic policies (as contrasted with existing lobbying projects for public health improvements, or climate mitigation, or animal welfare fixes) tend to be more controversial and not universally acknowledged as "good".

People who accept longtermist arguments (that we should just aim for highest-expected-value, even amid crazy high uncertainty and even if that causes us to pour everything into wild X-risk-prevention moonshots) mostly seem to jump all the way into standard longtermism.

As a pretty committed longtermist myself, I certainly see where these people are coming from. But all the arguments for why even longtermists should think it's good to have a neartermist component to EA (building up a legible reputation of altruism, getting practice actually accomplishing big things and building strong organizations, getting feedback loops, making sure that the movement is genuinely helping people rather than becoming too meta, etc) also apply to medium-term interventions. For all those reasons, I would like to see economic growth interventions join EA as another core pillar of the movement alongside animal welfare, x-risk reduction, and global heath.

Besides the idea that economic growth interventions have fallen into a medium-termist "gap", there are some other factors that also contribute:

freedomandutility @ 2021-12-03T15:00 (+7)

I second the need to focus on growth in LMICs, partly on the grounds of more money better translating to happiness for poorer people than for richer people.

But also, it seems like HICs benefit from more think tanks and people working on policy specific to their country, whereas LMICs seem to have fewer think tanks based in their own countries working on policy specific to that country, but I might be wrong about the numbers of think tanks and the benefits they provide.

John G. Halstead @ 2021-12-04T11:36 (+9)

Growth research is also a global public good so we should expect it to be underprovided, and for more of it to be a very good thing

John G. Halstead @ 2021-12-04T11:32 (+14)

As I understand it, no there has been no additional effort into researching economic growth, nor has anyone responded to either of the posts you mention.

There has been some new research into policy change air pollution in Asia.  

MaxG @ 2021-12-02T12:19 (+13)

One thing that came to mind is that in the last year, it seems the EA community has payed more attention to the progress studies (PS) movement. They probably take an approach to global health and poverty which is more focused on economic growth. 

tylermaule @ 2021-12-04T16:13 (+7)
  1. As Jackson points out, those willing to go the 'high uncertainty/high upside' route tend to favor far future or animal welfare causes. Even if we think these folks should consider more medium-term causes, comparing cost-effectiveness to GiveWell top charities may be inapposite.
  2. It seems like there is support for hits-based policy interventions in general, and Open Phil has funded at least some of this.
  3. The case for growth was based on historical success of pro-growth policy. Not only is this now less neglected, but much of the low-hanging fruit has been taken.
jlemien @ 2021-12-10T12:24 (+2)

I'll add one small comment regarding this. I think that the claim that "resources devoted toward economic development tends to do more good than resources toward small-scale health interventions" makes sense. On three different occasions when I've mentioned randomized control trials as a great way for creating new knowledge, I've had EAs refer me to this article as if this article was a critique of RCTs. Thus, I suspect that multiple people have misinterpreted the aim of the article, and are mentally categorizing it as "a critique of RCTs" rather than as "a critique of small scale interventions as less effective than economic growth."