Sign of quality of life in GiveWell’s analyses

TLDR: Sure, the 30% seems quite high, although if the price of alternative fertilizer is around double, it could be accurate for many subsistence farmers.

I have the 30% from this cited text and the BOTEC. In the sheet, 30% seems to be subtracted from the overall cost-effectiveness that considers qualitative adjustments (E77 in "Calculations").  "Calculations" E58 specifies 70% adjustment due to -30% due to risk of agricultural harm ("Assumptions" E36). This 70% multiplies other qualitative adjustments (E60), which multiply the cost-effectiveness before qualitative adjustments (E76) to get cost-effectiveness after adjustments (E77).

The number does seem high, though, especially considering that substitutes seem available. However, it may also be accurate, if farmers are able to afford less fertilizer due to its higher price. One Acre Fund (OAF) RCT-based analysis cites about 50% improvement in yield (in a different region) when farmers are given a loan to purchase (and trained to use) fertilizer and improved seed variety (fertilizer:seed cost is about 2:1^[1]). Based on anecdotes from The Last Hunger Season, some farmers cannot afford fertilizer.

The price difference between the highly hazardous pesticides and alternatives is not stated, although pesticides constitute only 7.5% of input costs. However, the document (pp. A-12 - A-13 or 58-59 in the pdf) cited by GiveWell that gathers statistics on farm inputs considers relatively high costs for farm labor and land rent which in the case of subsistence farmers can be neglected (thus the cost would be much higher than 7.5%). There is also very high variance among states in India. Some states seem to use much less fertilizer (e. g. 2.5% of seed costs in Mizoram) than others (39% of seed costs in Andhra Pradesh). Thus, it is unclear to what extent any increases in fertilizer price affect yield.

Further, GiveWell cites that

[p]esticides commonly used for suicide may be more convenient, or have a different mechanism of application, in which case agricultural workers will incur some costs in learning how to use replacements.  

Farmers in "The Last Hunger Season" were not trained in fertilizer use prior to the OAF program. It can be that farmers who pay attention to using fertilizer correctly will do so even if another type is offered and vice versa. India's growing network of rural e-centers with agricultural information can provide appropriate fertilizer information. In other countries of CPSP operations, farmers may be less informed. Thus, any decrease in agricultural productivity due to unfamiliar fertilizer use can be limited.

A professor conducted research on the substantiation of sentiments on counterfeiting. It could be possible that when a new type is introduced, farmers will be suspicious. This can be temporary or have limited effect (trust in local retailer not brand).

(More costly) fertilizer can also substitute other items that increase life quality, such as food, education, or health. Thus, even if a higher cost does not lower yields, the -30% (or other) adjustment could still be valid due to the effects of counterfactual spending.

I understand that GiveWell is assuming a 0.3 agricultural productivity decrease high estimate and 0 or 0.01 low estimate. The high estimate is used, while numbers with 0 decrease are cited next to the adjusted ones, possibly due to high uncertainty about the complex effects on agriculture. 

So far, I only considered the effects on smallholders. Effects on industrial farms may be much more substantial, even if the price difference is in the order of percent. I assume that in India, most farms are subsistence. That should be 85% (by land holdings?) in Uttar Pradesh. I further assume that industrial productivity is about 5-10x that of subsistence farm (about 1/2-1/3 of land can be used in subsistence compared to commercial and productivity can be about 2-3x lower). This would suggest that commercial farms produce about as much (Fermi estimate) as subsistence farms (15%*5=75%≈85% or  (15%*10=150%≈1.8*85%).

In areas where subsistence farmers use little chemical fertilizer, productivity decrease can be negligible (and much lower than that in commercial agriculture). Conversely, in regions where smallholders spend significant proportions on fertilizer, they can be affected disproportionately more than industries. The former suggests that the median would be close to 0 and mean would be the average of the commercial effects and 0 (e. g. 2% if commercial outputs fall by 4%). The latter can suggest a median value of >30% and mean value of the half of that.

The median would be 30% and mean around 0 if few farmers constitute a large majority of output and are relatively unaffected, while the majority of smallholders are affected significantly. This is what makes intuitive sense, upon the assumption that industrial agriculture largely outperforms subsistence in output and can flexibly (with negligible per unit cost) switch to alternative (or is already using it). However, this can be a biased perspective based on the knowledge of US and other developed economies' agriculture. While the rapidly industrializing India is the largest nation among CPSP partners, other beneficiary countries can be less industrialized. 

Secondary effects from forgone commercial agriculture taxation (as well as any decreases in International competitiveness of beneficiary nations) that can support large proportions subsistence farmers could be discussed.

Lower fertilizer use could lead to higher rents accrued to farmers, if their product is sold as organic with a premium.

Another consideration is that CPSP on its previous website cited investigating the possible negative effects on agricultural productivity in Sri Lanka (listing this on the website can suggest a significant concern). This can be considered in conjunction with GiveWell's cited enthusiasm and great fit of the professor who leads the project/applied for the grant (he could be motivated to gather and interpret evidence in a way that highlights benefits and unhighlights risks).

The effects of highly hazardous pesticides on agricultural productivity (and the impact on populations) will depend on the

• Price and effectiveness differences between the currently and newly used fertilizer for smallholders and commercial farmers
• Willingness and ability of subsistence farmers to learn any new fertilizer use techniques
• Ratio of subsistence and commercial farms
• Use of commercial agriculture taxation on smallholder productivity
• Price premium for no chemical fertilizer use
• Agricultural productivity units (tons, monetary value, % of farmers not experiencing hunger, ...)

Guessing these values, measuring productivity in real local currency units and considering effects only on smallholders, based on the above discussion, the decrease can have a mean of 0.04 with SD=0.02 and be normally distributed, with possible other distributions based on country or region.

1. ^{^}

   One Acre Fund provides $75-80 loans for fertilizer and seeds. 10kg of improved corn seeds costs 70,000 UGX. 10-15kg is needed for an acre (used 100,000 UGX or about $25). Based on the book and confirmed by Global Partnerships, the average farm size is about one acre. $25/$75=1/3, so about 1:2.

1. I looked at the graph on page 42 (the bar for Kenya is 2.3), but actually had the statistic from HLI, which cites it. The 2.8 (p. 40) is the survey average. Good catch for HLI (and myself, unless I am further misreading), which can make it seem as if the Kenyan sample was 1,808 and SD=2.32.
2. OK, I was actually unaware of that (clearly was skimming the HLI page for bias confirmation - or, rather, made a note of an alarming statistic when skimming). I added the 4.5 value from the 2019 World Happiness Report also cited by HLI. This averages closer to 3.9/10, which is the LS estimate for GiveDirectly beneficiaries.

As a start, most people who have a non-fatal suicide attempt don't attempt again. This article suggests the broad pattern  following a first non-fatal suicide attempt is ~70% don't attempt again, 20% attempt but don't succeed, and 10% commit suicide. 

I couldn't find much that was directly relevant to long-term quality of life, but this very small French study looked at 29 adolescents who had attempted suicide, and followed up 10 years later (with significant potential for selection bias - only two thirds could be traced and of those, two thirds responded). Over 75% said they were happy in their personal lives,  over 50% were satisfied or very satisfied with their professional lives, and 2/3rds had no significant psychiatric problem reported. 17% had an ongoing chronic psychiatric problem, and 14% were in-between these groups. 

This study looked followed up physical trauma cases in adults - they found 65 patients who had the trauma due to a suicide attempts, and followed them up at 6+/- 3 years. 14% had died before follow-up, none due to suicide and all were reported as coping well by next-of-kin. 3 patients couldn't be traced and 2 declined follow-up. Psychosocial measurements of follow-up patients suggested a majority had decent functioning, with around 20-25% experiencing severe impairment of some kind. None had re-attempted suicide. 

I suspect that the key determinant of quality of life after attempting suicide is mental illness, especially depression, and not the suicide attempt itself. But I'm uncertain about this, and even more uncertain given both the literature and my clinical training are based on a high-income country context - things could be very different in low/middle-income countries or those in absolute poverty. 

Based on this kind of observation, it seems to me that most people want to live. My personal, subjective, moral view is that it would be wrong to assign a different moral weight to their lives.

Let me challenge you here. Suppose that in a community inspired by Tsangano, Malawi, where people used 71% of nets which they freely received, the quality of life is -0.2 with an SD of 0.3 (normally distributed). 60 km away, in a place visually similar to Namisu, Malawi (where people used 95% of nets), the quality of life is 0.3 with an SD of 0.2. Each community has 2,000 people (who need about 1,000 nets). You have only 500 nets.

Who are you going to give the nets to?

Further challenge: You also have a pre-recorded radio show that improves farmers' agricultural productivity by coaching them to place only 1 grain 75 cm apart and cover with a few cm of soil rather than scattering the grain. This can increase people's productivity by an average of 20%. The airtime for the show in one community costs as much as 500 nets.

Are you going to forgo any nets and buy the show?

Are you subjectively assigning equivalent moral weights to the lives of the people in the two hypothetical communities?