Global health & development
Global health
Improving public health, and finding new interventions to help the developing world

Quick takes

USAID has announced that they've committed $4 million to fighting global lead poisoning!  USAID Administrator Samantha Power also called other donors to action, and announced that USAID will be the first bilateral donor agency to join the Global Alliance to Eliminate Lead Paint. The Center for Global Development (CGD) discusses the implications of the announcement here.  For context, lead poisoning seems to get ~$11-15 million per year right now, and has a huge toll. I'm really excited about this news. Also, thanks to @ryancbriggs for pointing out that this seems like "a huge win for risky policy change global health effective altruism" and referencing this grant: In December 2021, GiveWell (or the EA Funds Global Health and Development Fund?) gave a grant to CGD to "to support research into the effects of lead exposure on economic and educational outcomes, and run a working group that will author policy outreach documents and engage with global policymakers." In their writeup, they recorded a 10% "best case" forecast that in two years (by the end of the grant period), "The U.S. government, other international actors (e.g., bilateral and multilateral donors), and/or national LMIC governments take measurable action to reduce lead exposure—for example, through increased funding for lead mitigation and research, increased monitoring of lead exposure, and/or enactment of regulations." We've reached this best case and it's been almost exactly two years! (Attributing credit is really hard and I have no experience and little context in this area — as far as I know this could have happened without that grant or related advocacy. But it's still notable to me that a CGD report is cited in Power's announcement.)
Often people post cost-effectiveness analyses of potential interventions, which invariably conclude that the intervention could rival GiveWell's top charities. (I'm guilty of this too!) But this happens with such frequency, and I am basically never convinced that the intervention is actually competitive with GWTC. The reason is that they are comparing ex-ante cost-effectiveness (where you make a bunch of assumptions about costs, program delivery mechanisms, etc) with GiveWell's calculated ex-post cost-effectiveness (where the intervention is already delivered, so there are much fewer assumptions). Usually, people acknowledge that ex-ante cost-effectiveness is less reliable than ex-post cost-effectiveness. But I haven't seen any acknowledgement that this systematically overestimates cost-effectiveness, because people who are motivated to try and pursue an intervention are going to be optimistic about unknown factors. Also, many costs are "unknown unknowns" that you might only discover after implementing the project, so leaving them out underestimates costs. (Also, the planning fallacy in general.) And I haven't seen any discussion of how large the gap between these estimates could be. I think it could be orders of magnitude, just because costs are in the denominator of a benefit-cost ratio, so uncertainty in costs can have huge effects on cost-effectiveness. One straightforward way to estimate this gap is to redo a GiveWell CEA, but assuming that you were setting up a charity to deliver that intervention for the first time. If GiveWell's ex-post estimate is X and your ex-ante estimate is K*X for the same intervention, then we would conclude that ex-ante cost-effectiveness is K times too optimistic, and deflate ex-ante estimates by a factor of K. I might try to do this myself, but I don't have any experience with CEAs, and would welcome someone else doing it.
Really interesting initiative to develop ethanol analogs. If successful, replacing ethanol with a less harmful substance could really have a big effect on global health. The CSO of the company (GABA Labs) is prof. David Nutt, a prominent figure in drug science. I like that the regulatory pathway might be different from most recreational drugs, which would be very hard to get de-scheduled. I'm pretty skeptical that GABAergic substances are really going to cut it, because I expect them to have pretty different effects to alcohol. We already have those (L-theanine , saffran, kava, kratom) and they aren't used widely. But who knows, maybe that's just because ethanol-containing drinks have received a lot of optimization in terms of taste, marketing, and production efficiency. It also seems like finding a good compound by modifying ethanol would be hard, because it's not a great lead compound in terms of toxicity (I expect).
The Happier Lives Institute have helped many people (including me) open their eyes to Subjective Wellbeing and perhaps even update us to the potential value of SWB. The recent heavy discussion (60+ comments) on their fundraising thread disheartened me. Although I agree with much of the criticism against them, the hammering they took felt at best rough and perhaps even unfair. I'm not sure exactly why I felt this way, but here are a few ideas. * (High certainty) HLI have openly published their research and ideas, posted almost everything on the forum and engaged deeply with criticism which is amazing - more than perhaps any other org I have seen. This may (uncertain) have hurt them more than it has helped them. * (High certainty) When other orgs are criticised or asked questions, they often don't reply at all, or get surprisingly little criticism for what I and many EAs might consider poor epistemics and defensiveness in their posts (for charity I'm not going to link to the handful I can think of). Why does HLI get such a hard time while others get a pass? Especially when HLI's funding is less than many of orgs that have not been scrutinised as much. * (Low certainty) The degree of scrutiny and analysis of some development orgs in general like HLI seems to exceed that of AI orgs, Funding orgs and Community building orgs. This scrutiny has been intense- more than one amazing statistician has picked apart their analysis. This expert-level scrutiny is fantastic, I just wish it could be applied to other orgs as well. Very few EA orgs (at least that have been posted on the forum) produce full papers with publishable level deep statistical analysis like HLI have at least attempted to do. Does there need to be a "scrutiny rebalancing" of sorts. I would rather other orgs got more scrutiny, rather than development orgs getting less. Other orgs might see threads like the HLI funding thread hammering and compare it with other threads where orgs are criticised and don't eng
PEPFAR, a US program which funds HIV/AIDS prevention and treatment in the developing world, is in danger of not being reauthorized.[1] (The deadline is September 30th, although my current understanding is that even if the House of Representatives misses the deadline, it could still be reauthorized, there would just be a delay in funding.) Over the course of its existence, it's estimated as saving ~25 million lives[2] for a little over $100 billion, and my current understanding is that (even if the lives saved number is an overestimate) it's one of the most cost-effective things the US government does. I think it might be worth calling your representative to encourage them to reauthorize PEPFAR, particularly if they've indicated that they're uncertain of how to vote or might vote against it. My main uncertainty here is that I'm not sure how likely calling your representative is to actually change their mind, but I suspect this is fairly tractable compared to most forms of lobbying since it's literally just asking them to reauthorize a program that already exists (as opposed to asking them to pass a new law, majorly change how a program works, etc.) 1. ^ 2. ^ (note that some sources think this is an overestimate - e.g. the comments section here thinks it could be more like 6 million as a low estimate, which would make it not competitive with GiveWell top charities, though still way more cost-effective than a lot of things the US government does (and I currently don't expect that if the program were eliminated the money would be redirected to something more cost effective))
Radar speed signs currently seem like one of the more cost effective traffic calming measures since they don't require roadwork, but they still surprisingly cost thousands of dollars. Mass producing cheaper radar speed signs seems like a tractable public health initiative
According to Kevin Esvelt on the recent 80,000k podcast (excellent btw, mostly on biosecurity), eliminating the New World New World screwworm could be an important farmed animal welfare (infects livestock), global health (infects humans), development (hurts economies), science/innovation intervention, and most notably quasi-longtermist wild animal suffering intervention.  More, if you think there’s a non-trivial chance of human disempowerment, societal collapse, or human extinction in the next 10 years, this would be important to do ASAP because we may not be able to later. From the episode: Dropping a longer quote with more context in this footnote.[1] A quick Google Images search makes this all the more visceral, but be warned that it's kinda graphic. I would really love to see someone (maybe me) do a deeper dive into this and write up a proper Forum post.    1. ^
I'm interviewing Rob Mather, founder and CEO of AMF this evening at 6pm UTC. I'm asking him the questions from the comments on this AMA post. Let me know, on that post or here, if you have any questions which you'd like to ask him.  You'll be able to watch the event live (on a link I'll post here and on the AMA post before the event at 6pm UTC), or as a recording before the end of the week.  [Edit: It will not be before the end of the week. Sorry about that! Happy Holidays everyone, expect this in the new year].   
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