How many of us on this forum have the privilege of debating the best place to put billions of philanthropic dollars, without worrying about our next meal, or the untimely death of our child? How many people in the world are faced with the latter two problems, right now? How many of us on this forum have the privilege of discussing COVID-19 as a nuisance to our travel, social events, and daily activities? Meanwhile, how many people remain unvaccinated (or are dead) because of lack of access in impoverished countries? How many have lost their livelihood, or family members?

I may be (correctly) accused of identifying with the effective altruism of Peter Singer’s Famine, Affluence and Morality essay of 50 years ago, and not have moved on to more erudite EA questions, but how can we ignore making a difference now?

Today I had the surreal experience on the "Civil Society Organizations - WHO Director General Dialogue on Sustainable Financing" webinar of listening to Dr. Tedros essentially begging for more funds for the World Health Organization, and then I checked Twitter to find EA has more money than they know what to do with.

Often the EA community excuses global health as being adequately supported by Bill and Melinda Gates, but clearly it is not. Having worked in health care in impoverished countries I know global health is not adequately funded. Rohingya refugees in Bangladesh are dying of malnutrition because they are only rationed rice from the World Food Program. Yemeni internally displace people must leave the IDP camp just to access water. Afghan children are dying by the hundreds of not only vaccine-preventable diseases, but starvation.

I would suggest improving global equity is a longermism effort, both near and far. Lives saved, lessons learned, improving the health and well-being of current people, can only improve the lives of future people. Promoting total expected wellbeing must include current people. The more lives saved right now increases the chance one person will improve AI alignment, while another will create a sustainable form of energy, and another develop an effective policy on climate change. At the very least, it has been shown that equity improves the health and well being of all members of society, not just the poor. 

Please tell me what are the drawbacks to investment in improving global equity?




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~50% of Open Phil spending is on global health, animal welfare, criminal justice reform, and other "shortermist" and egalitarian causes.

This is their recent writeup on one piece of how they think about disbursing funds now vs later

Thank you, I have read the Global Health and Wellbeing portfolio and listened to Alexander Berger's podcast, but I am still left with the question, are they doing enough? Are their causes sufficiently broad?  Have they left stones unturned?  What innovative cause has been missed? I can't help but think this is a too-easy dismissal of the circumstance, and risks missing opportunities to save lives in very effective cause areas

(When I say 'we' I mean 'me, if I had control over the EA community'. This is just my view, and the actual reasons behind funding decisions are probably somewhat different)

Well, I'm not sure about the numbers but I'd say a pretty substantial percentage of EA funding and donations is going to GiveWell-style global health initiatives. So it's not like we are ignoring the plight of people right now.

The reason why there is more money that we can spend is that we don't know a lof of effective interventions to reduce say, pandemic risk, which scale well with more money.

We could just spend all that money on interventions that might help, like trying to develop broad spectrum antivirals, but it's legitimately a hard problem and it's likely that we would end up with no more money to spend without having solved anything.

Going back to improving equity, the three people you mentioned (rohingya, yemeni, afghan) are victims of war and persecution. The root causes of their suffering are political. We could spend hundreds of billions trying to improve their political system so that this does not happen again, but Afghanistan itself is an example of just how hard that is.

In short, even though helping people now is very valuable, we also don't know a lot of interventions that scale well with money. Malaria nets and deworming are the exception, not the rule. Remember that the entire world has been trying to eliminate poverty for centuries. It's just a hard problem.

Maybe paying for vaccines in lower income countries is an effective and scalable intervention. The right way to evaluate this is with a cost-benefit analysis, not by how much money the WHO says it needs.

Yes, I agree on the point that interventions are best assessed with cost-benefit analysis, rather than propping up inefficient institutions.  I was not necessarily suggesting support for WHO, only indicating that the  purported leader in global health is spending more time fundraising than leading. 

I, perhaps mistakenly, thought EA, particularly Open Phil, was about funding high risk, low yield, but fat tail causes, vs the "sure thing" that Give Well funds. 

For pandemic risk, what about funding campaigns to back the TRIPs waiver proposal for all pandemic vaccines?

For people of conflict-affected countries, what about supporting impartial organizations which can access people in need? Advocate for impartial access? The latter would scale well, if effective, because the entire southern Afghanistan is unvaccinated against every childhood disease, not just COVID.

I agree with you, when the root cause of suffering is political, the solution is complicated, and improving the political system would be costly and ineffective. This is why I think the creativity of the EA community could be so beneficial, by seeking other solutions.

I welcome the counter-arguments on this, but I think the writer makes a fair point around protecting current institutions and systems which are weakening due to political changes / pressure / defunding. It isn't ideal when countries withdraw funding from the WHO; and arguably if institution X was less reliant on funding from nation states, it would also be likely less beholden to them politically.  More beholden to philanthropists, so here comes the private actors Vs. states as funders debate again, which I'm not going to put forward a solution to now as much as say "it's an debate alright".

These institutions aren't perfect by any means - the masks debacle by the WHO being a case in point - but a question is if it didn't exist as a mechanism for near - and long-term health protection, would we suggest it should be founded? Answer is likely yes; so if they are underresourced, why not consider funding.

More controversial perspective: the message going round now is "we have lots of money, we just want to keep the bar high for what we do with it; ergo be ambitious". So I think it's fair enough to say "maybe making sure health protection / poverty alleviation systems to keep the world going in the right direction are fit for increased funding in the absence of these more ambitious and fitting ideas being put forward"...  

I guess I'm saying what's the appropriate default? Very high bar for innovative long-term ideas seems reasonable because this is an emerging field with high uncertainty. But lower bar for ways in which the world is on fire now, and where important institutions could get worse / lead to worse outcomes if defunding / underfunding continues?

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