One argument in favour of funding deworming, despite uncertain effects, is that
- the expected value is high because the estimated effect size is slightly positive and the direct costs of deworming are low
- the quality of evidence is high (RCTs) (compared to many other initiatives which get funded by EA)
I think this excludes a third key consideration in prioritising causes, which is the potential for ongoing evaluation, both in terms of quality of evaluation and timescales for evaluation.
Imagine that we have 2 interventions, intervention A and intervention B.
Both have the same estimated effect size where the central estimate is positive, but there's a chance the effect is negative: +0.05 (95% Confidence Interval from -0.25 to +0.35)
Both have the same quality of evidence: Effect size estimated from a meta-analysis of 5 RCTs
But Intervention A has marginally greater expected value because it's cheaper to implement
and
Intervention B would be much cheaper to evaluate through ongoing observational studies
In this case, I think we should fund Intervention B because of the value of being able to course-correct and update our estimated expected value based on more cheaply accessible new evidence.
If EA continues to fund deworming in the long-term, but further testing of effects via RCTs or monitoring of effects via observational studies doesn't occur, there's a risk that millions could be spent sub-optimally.
I think EA should either:
- also fund further evaluation of deworming, or
- prioritise interventions with better expected value or better quality of evidence or potential for cheaper, higher quality or faster further evaluation, over deworming
Neat idea. I think this is probably true.