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

Quick takes

32
9d
4
Bill Gates: "My new deadline: 20 years to give away virtually all my wealth" - https://www.gatesnotes.com/home/home-page-topic/reader/n20-years-to-give-away-virtually-all-my-wealth
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14d
1
Since my days of reading William Easterly's Aid Watch blog back in the late 2000s and early 2010s, I've always thought it was a matter of both justice and efficacy to have people from globally poor countries in leadership positions at organizations working on global poverty. All else being equal, a person from Kenya is going to be far more effective at doing anti-poverty work in Kenya than someone from Canada with an equal level of education, an equal ability to network with the right international organizations, etc. In practice, this is probably hard to do, since it requires crossing language barriers, cultural barriers, geographical distance, and international borders. But I think it's worth it. So much of what effective altruism does, including around global poverty, including around the most evidence-based and quantitative work on global poverty, relies on people's intuitions, and people's intuitions formed from living in wealthy, Western countries with no connection to or experience of a globally poor country are going to be less accurate than people who have lived in poor countries and know a lot about them. Simply put, first-hand experience of poor countries is a form of expertise and organizations run by people with that expertise are probably going to be a lot more competent at helping globally poor people than ones that aren't.
72
4mo
2
Update (January 28): Marco Rubio has now issued a temporary waiver for "humanitarian programs that provide life-saving medicine, medical services, food, shelter and subsistence assistance."[1] PEPFAR's funding was recently paused as a result of the recent executive order on foreign aid.[2] (It was previously reauthorized until March 25, 2025.[3]) If not exempted, this would pause PEPFAR's work for three months, effective immediately. Marco Rubio has issued waivers for some forms of aid, including emergency food aid, and has the authority to issue a similar waiver for PEPFAR, allowing it to resume work immediately.[4] Rubio has previously expressed (relatively generic) positive sentiments about PEPFAR on Twitter,[5] and I don't have specific reason to think he's opposed to PEPFAR, as opposed to simply not caring strongly enough to give it a waiver without anyone encouraging him to. I think it is worth considering calling your representatives to suggest that they encourage Rubio to give PEPFAR a waiver, similarly to the waiver he provided to programs giving emergency food aid. I have a lot of uncertainty here — in particular, I'm not sure whether this is likely to persuade Rubio — but I think it is fairly unlikely to make things actively worse. I think the argument in favor of calling is likely stronger for people who are represented by Republicans in Congress; I expect Rubio would care much more about pressure from his own party than about pressure from the Democrats.   1. ^ https://apnews.com/article/trump-foreign-assistance-freeze-684ff394662986eb38e0c84d3e73350b 2. ^ My primary source for this quick take is Kelsey Piper's Twitter thread, as well as the Tweets it quotes and the articles it and the quoted Tweet link to. For a brief discussion of what PEPFAR is, see my previous Quick Take. 3. ^ https://www.kff.org/policy-watch/pepfars-short-term-reauthorization-sets-an-uncertain-course-for-its-long-term-future/ 4. ^ htt
7
9d
I liked Bob Jacob’s essay Is Effective Altruism neocolonial?. Aid dependency is a really interesting problem, where charities can become victims of their own success. I think we should be very thoughtful about counterfactual government funding—even when, due to natural government inefficiencies, it might be less cost-effective. One place I think EAs can do a lot of good is in charity entrepreneurship. There are often good emerging ideas that need a strong evidence base before governments will adopt them, but a shortage of ambitious people willing to take these risks. At Kaya Guides, we see our role as pioneering a novel treatment method, and then working with governments to implement. Even if we don’t do this ourselves, our counterfactual impact will always have been to create an evidence base that encourages others to do so!
23
2mo
2
Buried deep in the PEPFAR Report's appendix - methodology section is a nice "introduction to global health programs" mini-article that also addresses some lay misconceptions about foreign aid and suggests a better way to think about it all in one go; it's a shame that most folks won't read it, so I'm reposting it here for ease of future reference.
66
6mo
During the animal welfare vs global health debate week, I was very reluctant to make a post or argument in favor of global health, the cause I work in and that animates me. Here are some reflections on why, that may or may not apply to other people: 1. Moral weights are tiresome to debate. If you (like me) do not have a good grasp of philosophy, it's an uphill struggle to grasp what RP's moral weights project means exactly, and where I would or would not buy into its assumptions. 2. I don't choose my donations/actions based on impartial cause prioritization. I think impartially within GHD (e.g. I don't prioritize interventions in India just because I'm from there, I treat health vs income moral weights much more analytically than species moral weights) but not for cross-cause comparison. I am okay with this. But it doesn't make for a persuasive case to other people. 3. It doesn't feel good to post something that you know will provoke a large volume of (friendly!) disagreement. I think of myself as a pretty disagreeable person, but I am still very averse to posting things that go against what almost everyone around me is saying, at least when I don't feel 100% confident in my thesis. I have found previous arguments about global health vs animal welfare to be especially exhausting and they did not lead to any convergence, so I don't see the upside that justifies the downside. 4. I don't fundamentally disagree with the narrow thesis that marginal money can do more good in animal welfare. I just feel disillusioned with the larger implications that global health is overfunded and not really worth the money we spend on it. I'm deliberately focusing on emotional/psychological inhibitions as opposed to analytical doubts I have about animal welfare. I do have some analytical doubts, but I think of them as secondary to the personal relationship I have with GHD.
42
4mo
3
I just learned that Trump signed an executive order last night withdrawing the US from the WHO; this is his second attempt to do so.  WHO thankfully weren't caught totally unprepared. Politico reports that last year they "launched an investment round seeking some $7 billion “to mobilize predictable and flexible resources from a broader base of donors” for the WHO’s core work between 2025 and 2028. As of late last year, the WHO said it had received commitments for at least half that amount". Full text of the executive order below: 
21
2mo
For the tax nerds, cool event next week from the OECD: Tax Inspectors Without Borders: A decade of niche assistance to developing countries 12 March 2024 | 13:45 - 14:45 CET https://www.tiwb.org/resources/events/oecd-tax-and-development-days-2025-tiwb-a-decade-of-niche-assistance-to-developing-countries.htm 
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