Cross-posted from my blog. I question if AMF is the most cost-effective way to do good on a range of views of population ethics and the badness of death.

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In advance of the Christmas charity season, GiveWell has announced that the Against Malaria Foundation (‘AMF’) is once again their top pick for the world’s most effective charity. The explanation for this is quite straight forward: AMF provides bednets that stop very young children (mostly under-5’s) dying prematurely from malaria. GiveWell estimate, although this is not to be taken too seriously, $3,500 to AMF saves a child’s life. More specifically, that $3,500 buys 35 ‘QALYs’ (Quality-Adjusted Life Years), which is a more technical way of saying it creates 35 years of healthy life for the beneficiary. At first glance, AMF is highly cost-effective and does a lot of good. In many ways, the focus amongst effective altruists on saving lives smoothly follows from Peter Singer’s exhortation in his essay Famine, Affluence, and Morality that no decent person would walk past a drowning child. Many effective altruists (‘EAs’) enthusiastically encourage others to donate to AMF rather than their previously preferred charities, and many EA organisations, such as meta-charity Giving What We Can, use it as their leading example of how to do good better.

I believe this enthusiasm is mistaken. I doubt many effective altruists, whatever their views are on population ethics, should believe AMF is the most cost-effective way to do good. I’ll outline five different ways you can think about the value of creating and ending life. Together, they seem to exhaust the relevant possibilities. I’ve shown these in the 2 by 2 box below. I explain how much good AMF does according to each view. Then I suggest that, for each view, there are alternatives to AMF you should be tempted by instead. I’ve outlined my argument in skeleton form below. I don’t conduct a cost-effectiveness analysis of all the alternatives to AMF; that is outside the scope of this essay. So my suggestions should only be taken as suggestions. There are potentially other views in population ethics or other important considerations I’ve missed, so I would urge others to check my conclusions.

A more general worry is that effective altruists focus too much on saving lives rather than improving lives. This is understandable. ‘Saving lives’ is more motivating than ‘improving lives’. However, it’s obviously impossible to ‘save a life.’ Really, we should really talk about ‘delaying deaths’ or ‘lengthening lives’. And I take it that, if presented with a choice between extending one person’s life by an hour, or curing another from years of chronic pain, we would all choose the latter. Even if AMF is the best way to extend lives, it may not be the best way to do good. I would encourage other effective altruists to think hard about how saving lives should be compared to improving lives.

(Table 1. The value of creation and death, focussed solely on the individual who is created or dies.)

Death can be good/badDeath can’t be good/badCreation can be good/bad1. Total utilitarianism5. Reverse asymmetric viewCreation can’t be good/bad 2. Deprivation view3. Time-relative interest account4. Epicureanism 


The five types of views you could take:

1. Total utilitarianism

First, you could be a total utilitarian and believe the best outcome is the one with the greatest total happiness. You can’t say AMF causes more years of happy life in the world because it probably doesn’t. Because AMF saves lives it causes families to have fewer children – parents no longer feel they need to have as many children to ensure some make it to adulthood. By GiveWell’s own estimates, the effect of AMF is that it leaves total population numbers largely unchanged. This is the ‘replacement problem’ for total utilitarians because, in these replacement cases, they can’t say there’s much (or any) value in saving lives apart from the effects of bereavement on the parents. Total utilitarians should think AMF does no or little good and should probably support efforts to reduce existential risk (‘X-risk’) instead, but lots of them already think this.

I should note it's not particularly important what the exact replacement ratio is. If it turns out AMF causes parents to have 0.5 fewer children for every 1 life it saves, the total utilitarian should still halve AMF's effectiveness.

2. The deprivation account

The second and third options are person-affecting views. These depart from total utilitarianism by claiming that whilst there’s nothing good about creating people, it is important to save the lives of people who do already exist. The basic idea is that someone needs to exist first before you can say death harms them. There appear to be to (only) two ways to count the badness of death on these views.

There’s the deprivation account, which holds that the badness of death is equivalent the number happy years of life that person is deprived of. This is the view on which AMF appears to be most effective. However, it seems somewhat implausible. It implies aborting a 1-minute old foetus is a bigger loss to that foetus than death would be for a 20-year old (if we just consider the loss for the person that dies).

If you are seriously committed to the deprivation view you should probably think it’s better to fund research into life-extension rather than save lives by conventional methods such as AMF (credit to John Halstead for this point). Nick Bostrom has suggested the chance of developing radical life-extension in the next 100 years is at least 1%, so this isn’t an option that can be discounted of our hand. Some quick maths: suppose a breakthrough allowed 8 billion people to live just one year longer on average. That would appear to be as good as extending the lives of 228 million people by 35 years, or roughly equivalent to giving $800bn to AMF (assuming they kept their effectiveness as they scaled).

(Note: Michael Dickens has written about this on the EA forum saying GiveWell take a deprivationist view. I’m not sure the view is inconsistent in the way he says it is, but that’s not really relevant here anyway)

3. The time-relative interest account

The alternative to the deprivation view is Jeff McMahan’s time-relative interest account (TRIA). It holds the badness of death depends, roughly, on the extent to which it frustrates the person’s interests in continuing to live. This captures the intuition many people have that it’s much more important to save a 20-year old than a 1-minute old foetus because, in essence, that 1-minute old foetus hasn’t developed enough to miss out on life. Advocates of TRIA should think the good AMF does is much less than the number of life years it saves as AMF mostly benefits young children, the very people the view discounts. On TRIA, the greatest loss is when someone dies in their 20s: their brain and interests have developed, but they still have many years left to live.

It’s somewhat tricky to say, if this is the view you hold, whether AMF should be your top pick. You need to reduce Givewell’s estimate of AMF’s effectiveness by however much you discount child deaths compared to adult ones. Assuming the average child AMF saves is 2.5 years old (I’m guessing), does that make AMF ten times less effective than if they were saving 20-year-olds? Half? Fifty times? All the view says is there is some discount for very young deaths. Those who hold the view will need to work out what that discount is for themselves.

It also depends on how sad you think it is for others (i.e. parents) when someone dies. Givewell’s estimates don’t include the suffering the living feel, just the benefit to the child. I don’t attempt to do this here but I make two points. First, that people adapt to bereavement (as they do to everything else) so it likely only has an impact for several months (see Oswald and Powdthavee 2008). Second, we should realistically (and somewhat grimly) expect losing a child to be less bad (but still bad) in a developing world context where there is a greater expectation that children will die early anyway.

Once you’ve bundled those figures together for a new cost-effectiveness estimate, you may think AMF is now less cost-effective than alternatives, such as anti-poverty programmes (i.e. Give Directly), mental health interventions (i.e. Basic Needs), other physical health treatments (i.e. SCI) or animal welfare charities. For reference, GiveWell thinks AMF is 4x as effective as GiveDirectly and 0.5x as effective as SCI. As I argue in another draft paper, anti-poverty programmes seem to do surprisingly little to increase happiness, whereas mental health interventions are probably much more effective than they look on conventional health metrics. I haven’t looked into SCI or animal welfare so I won’t comment further.

4. Epicureanism

The fourth option is the Epicurean view, named after Greek philosopher Epicurus. It holds that there’s nothing good about creating someone and that death doesn’t harm anyone: once someone is dead, there is no them for anything to be bad. Obviously the process of dying can be painful. The point Epicureans make is that nothing is good or bad for you once you’re dead. On this account, the badness of death consists only in the suffering felt by the living.

For Epicureans, the value of their $3,500 donation to AMF is that it stops a family from having to grieve for a lost child. The question Epicureans need to ask themselves is whether that $3,500 could bring more happiness if spent on something else: anti-poverty, physical health, mental health or animal welfare interventions. Hence they are doing roughly the same calculation as advocates of TRIA, just not including the person that dies. Following my argument here, my guess is that if you want to increase human happiness, it’s more cost-effective to provide treatments for mental health than try to reduce child mortality in order to prevent parental grief.

5. Reverse asymmetrical view

The final option is what I called the reverse asymmetrical view. It combines the Epicurean view about death – that death is bad for no one – but also holds, like total utilitarianism, that it can somehow be good to create people. I don’t think this view has ever been discussed,  but there seems to be conceptual space for it on the two by two grid above. I take it to be totally implausible – it holds creating people and then killing them is good, not bad or neutral, so would actually hold AMF is counter-productive – and won’t say anything more about it. I only included it for completeness.


I’ll list and respond to objections as I receive them. So far I’ve had two objections when I’ve discussed this with other people.

The first objection is that I’m suggesting we shouldn’t save lives when we can easily do so. I think this is a misunderstanding. I buy Peter Singer’s argument that, if we benefit someone else greatly at minimal cost to ourselves, we should do so. This argument starts from the point we’ve already decided we want to benefit other people and no we’re trying to work out how important saving lives is compared to other things we could do. So I’m not saying, faced with a choice between saving a life and doing nothing, we should be indifferent. Rather, I’m saying, faced with a choice between saving lives or doing something else, we should do the one that is better. It’s not clear that’s always saving lives.

The second objection is that there is some sort of deontological requirement to save lives that there isn’t about improving lives. As someone who struggles to think in deontological terms, I’m not sure how this is supposed to work. Given that giving to AMF is a charitable act, I’d have thought it was supererogatory (i.e. beyond the call of duty) which means the main concern should be how much it benefits other people. Whether giving to AMF does benefit others depends on the view you take on death, which I’ve discussed above.


AMF doesn’t seem to be obviously the best choice on any of the mainstream views of population ethics, and is definitely sub-optimal on others. This suggests, unless GiveWell wish to take a single stance of population ethics and defend it, it’s somewhat odd to call it the world’s best charity. My thought is that those initially tempted by AMF should (re)consider their own views. I wonder if it’s time for EA organisations to be a lot clearer and cleaner about the philosophical assumptions their recommendations rest on.

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Hi Michael! Thanks for engaging with GiveWell research, we appreciate it. As others in the comments have pointed out, many of the critiques in your post would have applied to our earlier November 2015 cost-effectiveness analysis (CEA). Our 2016 CEA has changed a lot, in part because more staff engaged deeply with the kind of population ethics considerations you point out. Because of this, I think most people will not have to make substantial discounts to our 2016 cost-effectiveness estimate of the Against Malaria Foundation to account for their values. I wrote a longer response on the GiveWell blog here:

This post's philosophical implications - which has remained foundational to informing my donations - is explored further in OP's new charity research that he subsequently conducted:

Two quick things. Firstly I think many people give to GiveWell recommended charities because they believe, rightly or wrongly, that a healthier population will spur economic growth, or political reform, or whatever else, which will improve the welfare of present and future generations of people in the country. That argument would apply to total utilitarians, though be swamped by arguments relating to existential risks.

Secondly, GiveWell at least does not claim that AMF is the 'most best charity', but rather that it meets their four criteria here (evidence, cost-effectiveness, room for more funding and transparency): . But other people might accidentally start using loose language like 'best charity', and they probably shouldn't.

Firstly I think many people give to GiveWell recommended charities because they believe, rightly or wrongly, that a healthier population will spur economic growth, or political reform, or whatever else, which will improve the welfare of present and future generations of people in the country.

That argument, however, is vulnerable to the "suspicious convergence" objection.

Yo Rob.

yeah, I agree it's possible people support AMF for reasons other than that they think saving lives is important, but I've actually never heard anyone talk about it in those terms maybe other than you and Ben Todd. If that's why people support AMF, that also implicitly concedes the point that they don't do it because it saves lives. I have no idea how to think about AMF vs anything else in terms of economic growth, but I'd be curious to see the argument if someone else has made it. It strikes me there are more direct ways to spur growth or reform than stopping young children dying.

As to your 2nd point, that's not how Givewell sell themselves, given they talk about 'top charities'.

"GiveWell tries to help donors do as much good as possible with each dollar they give"

"We recommend charities according to how much good additional donations can do. We examine charities' overall quality and cost-effectiveness, as well as what more funding would enable them to do. We regularly publish discussions of our top charities' strengths and weaknesses"

If that's what GW say, but what they mean by best, when pushed, is "meets are 4 criteria" that a bit of a motte and bailey. Also, it's hard tot hink about cost-effectiveness is anything but moral terms.

[I hope it's not bad form to comment on a post from 2016 -- here it goes!]

Michael -- I'm a newcomer to EA. I find it very compelling but I've been troubled by the assumption that saving (or even generating) current (and future) lives is more valuable than improving existing lives. So I was excited to stumble upon your work. It has given me some intellectual basis for what was previously mostly intuition. What I have not been able to find is this: for someone who more or less shares your priorities / worldview, what should we be doing with our time and money? Can you point me to any resources on this? I imagine they exist but I'm having trouble finding them. The EA community has done an amazing job of evangelizing its favorite causes in a really accessible way (GiveWell etc); is anyone doing the same for causes that rank highly for those with alternative flavors?

GiveWell estimate, although this is not to be taken too seriously, $3,500 to AMF saves a child’s life.

It should be noted that their November 2016 estimate is that the marginal cost per under-5 death averted is $9,161 (B55 of the Bed Nets sheet), while the cost per life saved equivalent is $3,376 (B74 of the Bed Nets sheet).

Does that mean 2/3 of the estimated benefit comes from things other than averting deaths of children under 5?

That's my understanding. Based on B78, B79, and B80 of the Bed Nets sheet, it appears that 27% of the benefit comes from development effects, 36% of the benefit comes from adult mortality reduction, and 37% of the benefit comes from child mortality reduction.

Edit: GiveWell updated their spreadsheet to reflect the fact that what they previously labelled as the "percent of benefit coming from adult mortality reduction" is actually the "percent of benefit coming from age 5 and over mortality reduction" and what they previously labelled as the "percent of benefit coming from child mortality reduction" is actually the "percent of benefit coming from under 5 mortality reduction."

From this post: "This year, for most staff members, about 60%+ of the benefits of AMF in our cost-effectiveness analysis came from averting adult malaria mortality and improving childhood development, but the evidence base for both of these impacts is relatively limited."

Does that mean 2/3 of the estimated benefit comes from things other than averting deaths of children under 5?

By GiveWell’s own estimates, the effect of AMF is that it leaves total population numbers largely unchanged.

Where in that report does it say that, exactly? The summary at the top says that lifesaving interventions normally increase population:

Overall, it appears that life-saving interventions unaccompanied by other improvements, where access to contraception is weak, are likely to lead to some acceleration of population growth.

Furthermore, increased population compounds over time with the population growth rate. Saving a life several hundred years ago in the United States would have resulted in hundreds of additional lives over the subsequent generations.

It's just a couple of lines above in the box:

"The impact of mortality drops on fertility will be nearly 1:1, so population growth will hardly change."

Before the line you quote:

"Overall, it appears that life-saving interventions unaccompanied by other improvements, where access to contraception is weak, are likely to lead to some"

Re-reading it now, it seems weird GW would put two apparently contradictory statements next to each other.

I think my main point still stands. If you thought saving lives was good because you are a total util the more happy years the better, you should be less excited about AMF the more it doesn't cause there to be more happy years by altering population dynamics.

Note: You quote me as claiming that GiveWell adopts the deprivationist account. GiveWell's 2015 cost-effectiveness estimate for AMF implies a deprivationist view, but the 2016 estimate explicitly calculates the QALY-equivalent value of saving a 5-year old's life. This means there's not a single "GiveWell view" because the reported cost-effectiveness estimate takes the median of about a dozen GiveWell employees' individual estimates, but most employees appear to follow the time-relative interest account while a few adopt the deprivationist account.

Largely because of this change, GiveWell now claims that AMF is 4x as cost-effective as GiveDirectly, not 11x.

Thank for this! I'll admit I'm not up to date on Givewell's internal working. What is the difference between the deprivationist view and the QALY-equivalent of saving a 5-year old's life? Isn't the QALY-value of saving a life that the child would live until old age?

And yeah, I'm was just following you when you said there was a 'GiveWell view'. I know in your post you explain how it's a composition of staff views.

And thanks for 4x figure, I'll edit the article. I'd mistakenly used last year's figures.

What is the difference between the deprivationist view and the QALY-equivalent of saving a 5-year old's life?

It sounds like you're slightly misunderstanding me. GiveWell's 2015 estimate said that the value of saving a 5-year old's life was ~36 QALYs, which is a time-discounted estimate of the number of quality-adjusted years of life the 5-year old will now have. In the 2016 estimate, employees explicitly input how valuable they think it is to save a 5-year old in terms of QALYs--on the spreadsheet, look at the "Bed Nets" tab in the row "DALYs averted per death of an under-5 averted — AMF". The median value is 8.25, and estimates range from 3 to 26. The highest estimate, 26, is still lower than last year's estimate of 36, which suggests that none of the employees who filled this out adopt the deprivationist view.

And yeah, I'm was just following you when you said there was a 'GiveWell view'. I know in your post you explain how it's a composition of staff views.

Last year GiveWell's cost-effectiveness estimate used 36 QALYs per life saved, which implies a deprivationist view. That's not a composite of staff views, that's the result implied by GiveWell's reported cost-effectiveness numbers. It now appears that no GiveWell employees (or at least none who contributed to this cost-effectiveness analysis) actually hold a deprivationist view.

Okay. I've gone back to GiveWell's estimates, thanks. They look confusing and complicated, and it seems that quite a bit has changed in the past year.

I've spent 2-3 hours going over GiveWell's cost-effectiveness spreadsheet, so don't expect to understand it immediately. GiveWell has a video explaining how the 2015 spreadsheet works. I haven't much looked at the 2016 spreadsheet but it looks a lot better designed so it shouldn't take as long to understand.

My belief that AMF is a good donation opportunity are based on the belief that a malaria-free world is qualitatively better than one with malaria. It is based on beliefs such as the following (no one of which I probably have hugely rigorous proof for, but I broadly believe to be reasonable beliefs)

  • Deaths, especially of children, cause some sadness

  • Where parents have lots of children, there is less capacity to invest in any of them, so those children tend to be less likely to have a basic level of education

  • To the extent that malaria contributes to adult death, it (somewhat) leads to a society with a surfeit of young men, who are especially prone to be under-educated relative to their potential (see previous point) – this leads to a higher probability of violence and war.

  • To the extent that malaria contributes to adult death, it stops people from fulfilling long-term life plans to build things of value for society (e.g. companies, civil society)

  • (Linked to the previous point) Malaria slows economic growth, and economic growth is probably a good thing for the poorest societies

  • I would be worried about an argument against AMF’s work if I thought it would lead to explosive population growth that was too fast for infrastructure development to keep up – to a certain extent I think there is an element of valid worry here, but there is at least a partial self-regulating element (albeit with a lag) – this is what David Roodman’s post told us (or which we might have guessed by reading, e.g., work by Jeffrey Sachs)

I have reviewed GiveWell’s past CEA analyses with interest, but always imagined that measures like lives saved or QALYs were simply a simplification/proxy to get at the things we really care about – namely the sorts of things I’ve listed above. If my perspective on this is a minority view, this would come as a genuine surprise to me.

Unless I’ve misunderstood, the arguments that Michael has presented shouldn’t update my propensity to donate to AMF. More than happy to be educated if I’ve misunderstood

Hello Sanjay,

To be clear, I'm not arguing that AMF is a total waste of money every way you look at it. I'm arguing that, whichever view you take about population ethics, you should probably think an alternative is more cost-effective. I reckon this conclusion is still probably true for you, even once you take the things you've mentioned into account. I say 'probably' because I don't know what your exact moral views are, and there's quite a lot of empirical certainty anyway knowing the impact of AMF vs alternatives.

I'd be curious to know how what someone would spend your money as a donor if their goal was economic growth in the developing world. Is there something more effective than Give Directly? It sounds like your goal is less about creating/saving happy lives, and more about economic and civic development. It's not impossible, but I'd find it surprising (see my comment to R. Wiblin earlier) if a health intervention like AMF happened to be the best economic intervention too. To pour some cold water on AMF's economic effectiveness, GiveWell reckons AMF saves an under-5 for $9,000 dollars, so one for every 5,000ish bednets, and an adult (by which I think they mean over-5) for $38,000. My guess is there are better ways to spend $9,000 to boost growth than saving a child's life, if boosting growth is your aim.

I may be missing something here, but does the "replacement problem", which treats never having a child as the same as the death of a toddler, include the effects of child death on survivors? I'm not sure how morbidity and even mortality in bereaved parents compares to something like NTDs, but it's not nothing. ("Bereaved mothers in England and Wales (n=481) were more than four times as likely to die in the first 15 years after their child's birth than non-bereaved parents.")

Last I checked, GiveWell's analysis of AMF is based only on child deaths and doesn't consider other benefits like reducing the 30% of malaria fatalities that befall people five years and older, reduction of non-fatal cases of malaria, and economic effects of not having the workforce be sick so much. [Edit: I'm not sure about this paragraph, can no longer find this info, and maybe I was thinking of the cost-per-life saved number rather than the overall analysis anyway?]

hello Julia.

Replacement really just refers to the idea that one person's death causes another person to be born. This can go the other way too - saving a life causes someone else not to be born - which is what seems to happen with AMF. I don't know if these should have different names or something.

But no, replacement doesn't say anything about the parents. Total utils should account for that too, but note how much of the value of the intervention replacement removes. You thought you were giving a child 35+ years of life and preventing parental suffering, but now you're just (in effect) doing the former. If parental suffering is equivalent to taking away 1 year of happy life away from each parent (IMO, v unlikely), then AMF is equivalent to 2 happy years rather than 37+.

I run through some calculations here

I'm not sure about the other stuff they include either.

You thought you were giving a child 35+ years of life and preventing parental suffering, but now you're just (in effect) doing the former.

Do you mean the latter?

If parental suffering is equivalent to taking away 1 year of happy life away from each parent

I think we have very different intuitions here. I'd instantly give a year of my life to not watch my two-year-old daughter die, because I expect that 50 more years as a bereaved parent is worse than 49 years as the parent of a living child. I expect most parents would say the same (though of course social acceptability bias makes it more likely that parents will say that.) Also we may be getting into preference vs. hedonic utilitarianism here, not sure where I stand on that.

In general, though, this post does change the way I think about saving lives; thank you for writing it up.

I'd instantly give a year of my life to not watch my two-year-old daughter die, because I expect that 50 more years as a bereaved parent is worse than 49 years as the parent of a living child.

I would also do that, and probably be willing to do it at worse ratio (5 years, say).

There are also many situations where parents have given their lives to save their children, which is not coming from a "prefer shorter time with kids to longer time bereaved" assessment of their future.

Note that the GiveWell 2016 calculations allow us to take the amount of parental suffering into account--you can put your intuitions into the spreadsheet directly if you want.

I'd instantly give a year of my life to not watch my two-year-old daughter die

That's plausible from an evo-psych perspective as well. Ignoring the parenting that you can do while pregnant, a pregnancy costs a woman 3/4 of a year of life, plus various health risks and increased nutritional demands. Child care during the first year of the baby's life is also pretty costly. That probably adds up to more than 1 year of total cost just for the mother, and then some extra for the father, relatives, etc.

in response to your first point, yes I did mix those up.

And for the 2nd, I'm thinking hedonically and am leaning on the literature on hedonic adaptation. I'm not sure how to think about re-doing the calculations if I was using preferences util. So I think it's consistent to say "I would give up much more than a year of life to keep my child alive" whilst recognising that few (any?) events have a long term impact on happiness, either positive or negative.

I think the results on 'hedonic adaption' are much less straightforward than you think they are. In general I'd caution against making strong claims that completely go against common sense about people's preferences based on just reading a few studies.


Imagine two worlds:

In world 1 Alice is born. She sleeps under bednets and lives and proceeds to have children of her own 15-45 years after her birth. Alice's children make some more children, and they make some more, and more… And by the time our universe dies or the Earth is destroyed or humans are no more or humans stop having children, a million of people with Alice's genes have lived.

In world 2 Alice is born. She doesn't get a bednet and dies from malaria at age 4. Some (0-15) years after Alice's birth her parents create more children. On average they create 1 more child. That child, too, has children on their own, but it happens later than it would happen for Alice – about 10 years later. Because of that there will be only 500000 people with this little kid's genes. Total population of humans throughout the future will be smaller. Therefore less utilons (assuming total utilitarianism and some other ethical systems).

How come these researches don't calculate stuff like this? I wish they did. It seems extremely important even though I haven't figured out what population ethics I prefer.

I am not claiming that AMF is actually better than everything else. I am just making an objection, and hopefullt someone will research different charities' impact on populations size and happiness from now till the end of time.

I'm not an expert on population dynamics but I'm fairly certain it doesn't work like this. The rate of population growth is going to be affected by the existing population numbers at some point, either because the area becomes resource-constrained and people start dying in higher numbers of starvation etc, or parents who are educated and have access to contraception see that opportunity for their potential children is more limited and they choose to have fewer of them.

Some researchers do consider this sort of thing, such as Bostrom:

As I argued though, if you care about total utils over in this impersonal sense, you should probably support x-risk, not AMF.

Hi Michael, any chance you could fix the post so the table displays properly again? I continue to be surprised how I keep coming back to your table. 

Feel free to point me towards some other posts or sources you think is better than this post if your views have changed since I realize this post is relatively old.

This is ancient and i don't know much about many of the topics touched. But it made me wonder about four questions, which seen crucial to the argument:

  • What's the utility cost of parent bereavement and how to estimate it properly?

To unpack: One drawback of self reported life satisfaction and affect using Likert scales is the implicit request for a respondent to compare their current state against some standard. That standard may change with major life events, rendering comparisons before and after invalid. An alternative, direct way of estimating utility would be to ask bereaved parents: how much would you be willing to give to get your child back?

  • What's the utility cost of disability (rather than death) caused by malaria?

  • What's the evidence regarding the long term cost effectiveness of established mental health interventions such as CBT?

  • How well do we understand the concept of 'happiness' or what makes a 'good life' and how well do we need to understand these things to do different forms of good?

To identify the most efficient way of increasing net happiness for humankind overall, a lot of things need to be known, first of all what happiness is and how it can be quantified appropriately. For the psychometric concerns outlined above (and others), I think our understanding is a lot more rudimentary than that. If one accepts a 'little-gnostic' view regarding human happiness, it seems sensible to prioritise cases which are universally accepted as extreme forms of suffering - such as the loss of a child.

I'm really glad you posted this! I've found it helpful food for thought, and I think it's a great conversation for the community to be having.

I think AMF still looks like the best charity if you (a) are highly skeptical of interventions with relatively weak evidence and (b) adopt a "common sense" view of population ethics (which looks something like the time-relative interest account). But I do think these assumptions are both pretty unreasonable, and therefore their conjunction is even more unreasonable.

If you strongly discount interventions based on strength of evidence, that defeats life extension and deworming. I don't think it makes sense to care so much about strength of evidence that you prefer malaria to deworming, but it's possible to consistently prefer AMF.

I really, really don't think anyone should adopt the "common sense" view of population ethics (although obviously most people do in fact adopt it), because it's self-contradictory. If you do adopt the time-relative interest view, to avoid internal contradiction, you have to do something really weird like reject independence of irrelevant alternatives[1] or reject the transitivity of moral preferences[2]. I haven't explored these possibilities, but they probably have strong implications about which charities you should donate to, and it seems likely that AMF would not look best under them.

[1] Independence of irrelevant alternatives: If you have options A and B and you prefer A to B, then it is also the case that when you have options A, B, and C, you prefer A to B.

[2] Transitivity: If you prefer A to B and you prefer B to C, then you prefer A to C.

FWIW, I doubt very many people will realise they supported AMF because they were implictly deprivationists and will not support radical life extension instead. The point of my investigation was, any view you take, AMF doesn't appear to be a winner.

I guess someone could say "I'm a deprivationist but still support AMF because I'm risk-averse with my altruism" but I'd want them to have at least considered expected value of life extension in their calculations.

Can you give examples of time-relative interest account breaking [1] and [2], or a citation? I'm relatively ignorant of the maths here.

Well I discuss related issues here, but I'm not the first person to notice. Population ethicists have raised these issues many times before. I don't have any good references on hand because I learned about these issues from classes and discussions, not from reading papers; but here are some search results to get you started.

Edit: clarification

I think this is mixing up two issues issues. The time-relative interest account is really about the value of life at various ages.

It's one way someone with person-affecting intuitions might account for the badness of death. Deprivationist is an alternative.

From wikipedia (

"A person-affecting or person-based view (also called person-affecting restriction[1]) in population ethics captures the intuition that an act can only be bad if it is bad for someone.[2] Similarly something can be good only if it is good for someone. Therefore, according to standard person-affecting views, there is no moral obligation to create people nor moral good in creating people because nonexistence means "there is never a person who could have benefited from being created". "

the points about [1] and [2] are points about person-affecting views, rather than necessarily anything to do with the time-relative interest account.

The time-relative interest view is a type of person-affecting view, so if PAV breaks transitivity or independence of irrelevant alternatives then so does TRIV.

Re 2, the deprivation account, that matches closely with my views except that most people also carry equality (of opportunity at least if not outcome) as a value. Almost no people hold only one ethical value at a time. Holding equality as a value is why people are disgusted by the idea of the utility monster under total utilitarianism, which is a single being that deprives more pleasure from a unit of resources than any other being, and therefore under total utilitarianism should ethically get all resources despite the misery this would cause everyone else. The same principle can be applied to your point 2. Extending the life of 8bn people who already have a relatively-large number of years to live is not as good as redistributing those years so that the people with the least get more, so that we end up with a better balance than we do now. I say this as someone who has relatively more to gain personally from life-extension than insecticide nets -- if you had to pick between giving a year of extra life to someone who is already expected to live to 60+ or to someone who will die at 5, egalitarianism would suggest that you should give the extra year to the child who will die at 5. If you have 35 years to distribute among a population of 35 people, one of whom is expected to die at 5, and 34 of whom are expected to live to 60+, it also makes sense to give all 35 years to one who would die at 5. This is true regardless of whether you believe in equality of opportunity or outcome, assuming you believe that the other 34 people have done nothing to "earn" their extra years as compared to the person with a life expectancy of 5, which I do and I think most reasonable people would.

I agree, and I would even go farther, I would claim that the AMF should not simply be ranked below the top spot, but that it in fact does more harm than good. I live and work in international development in West Africa. Consistently bednet distributions provide short term benefits that organizations diligently document and cause long term economic and social harm that they conveniently ignore, because if they did not, they would be out of a job. They save lives at the expense of economic growth, freedom to choose, and community independence. Here's the full argument Stop Giving Well.

Is there a written version of this anywhere? I'm interested in the content of the argument, but I don't like video.

You can always try closed captioning, or simply muting the video and reading the screens, but here's a summary:

By donating goods instead of building capacity, AMF destroys jobs in developing countries since a mosquito net maker cannot stay in business when an international organization is donating thousands each year for free.

Each person that would be working in that factory often supports upwards of 20 people (as is frequently the case in developing countries). By putting them out of business you are destroying the support structure of hundreds of people.

AMF only monitors villages malaria risks for the lifetime of the mosquito net. They stop monitoring after the net is expected to break down. However since there are no commercial manufacturers (as they have all been put out of business by AMF) no one can buy a net themselves.

When AMF leaves an area, since the infrastructure to make the nets has been destroyed, people are unable to get quality nets, even if they wanted them, so the problem returns.

The economic harm that AMF does outweighs the benefits.

AMF also does not give communities choice in what they need. Here in West Africa, Malaria is seen very much like the flu, and worldwide the number of people that die from malaria is comparable to the die from the flu. Imagine that you need jobs in your small town, but a foreign NGO comes in and claims you need more flu shots to eradicate the flu. In fact they put your local doctors out of business by bringing in their own trying to eradicate it. Your community did not want flu shots, you wanted jobs, but this foreign NGO came in and ignored your right to choose your own intervention and did more harm than good. That is exactly what AMF does in villages here every day.

Hopefully that can give you some points to chew on. I personally live this every day and I have for years. I have always been concerned that the EA movement does not listen to the needs of the people, but instead decides what it thinks they need, and then forces it down their throats no matter the cost.

Considering that overpopulation is the main threat to the planet's survival, donating to the fight against malaria does not seem to be a priority. Africa's birth rate is already the highest, more children survive than ever. With even higher human population of people who refuse to use birth control, it will be the end of all African forest and animals. Where is my reasoning wrong? I fail to understand how decreasing malaria helps us as species to survive, it seems to accelerate our doom rather. Nobody talks about his aspect anywhere, as if fight against malaria was all good, with no side effects. Yet, side effects might be worse than cure. Vaccinations and antibiotics created overpopulation already. We need less people, not more. Where am I wrong, logically? (I wish I were).

You've brought up a common concern, one that many people have when they first learn about organizations like AMF. I'd recommend reading GiveWell's note on overpopulation on their "Frequently Asked Questions" page.

There are a few core arguments against the points you've made here:

1) Saving the lives of children can actually reduce population growth. Some research shows that birthrates tend to fall as child mortality decreases, because parents can feel more certain that they'll have at least some children who reach adulthood.

(This makes intuitive sense: if you have a three-year-old and a one-year-old in a country where 20% of children die between the ages of three and eighteen, you might want a third child to make sure you have a family legacy/companionship in your old age, where this wouldn't be the case if only 0.2% of children died between those ages.)

2) Overpopulation is good for the world, because every person born has the potential to contribute to solving our problems and making the world a better place. After all, denser cities tend to produce more companies and patents, and some of the world's most crowded nations are among its richest and most productive. A further point: Adding more people to the world could help us develop economically and reach a point where we can easily spread out into places that were previously too expensive/remote to inhabit, whether that's desert land or outer space.

3) Even if overpopulation is bad, it's still good to save the lives of children. Telling parents that they can't protect their families from malaria because we want to protect wildlife seems like the wrong moral path to take.

I won't get into my personal views on these points, but all three present opportunities to reconsider your views, if you'd like.

This is a good comment and is a perfect example of why the new system that seperates "upvote/downvote" and "agreement/disagreement" is a good idea.

I notice you haven't been active on the EA Forum since posting this comment. I hope you'll return one day! The downvotes here are likely more because people disagreed with you, not because they didn't appreciate your input. On the comments in newer posts you'll see that it is possible to both appreciate a comment but disagree with its contents (or vice versa think a comment is bad, but agree with its contents).

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