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Strategy Fellow at Open Philanthropy, working to help identify new cause areas within the Global Health and Wellbeing portfolio. Based in Brussels, grown in the UK.

Giving What We Can member since 2011. Previously earning to give as a strategy consultant.

Not the Chris Smith who used to work at GiveWell.

Tweets on global health, statistics, economics, feminism, and effective altruism at @chris_topian


Topic contributions

(I don't lead on the air quality work, so be more careful with this comment that the others that I've left here).

India wasn't picked as an example to illustrate the importance and neglectedness of air quality work. Rather, India has been the dominant setting for Open Philanthropy's air quality work to date - it even has its own updated web page. You can read more about why Open Philanthropy launched the work on South Asian air quality here and here. Santosh Harish, the Program Officer who leads that work, recently gave an excellent interview to the 80,000 hours podcast - transcript and recording here

I agree domestic financing complicates relative neglectedness - the effort here was to be as consistent as reasonably possible between the risk factors. Neglectedness comparisons are very tricky to nail down in general (e.g. how to attribute non-specific health systems spending across both causes and risks, whether to include treatment for linked health conditions like lung cancer or cirrhosis, how to think about relatively ineffective uses of money like e.g. biofuel subsidies for climate change, or a more relevant example here would be smog towers for air quality). One nod to the uncertainty of both measurement and scope here is the use of ranges; but yeah, we're trading off a bunch of different considerations here.

There's a lot of internal research stress testing the IHME burden estimates for lead and air quality, and some on alcohol - I'm doing more on alcohol specifically at the moment. Here we're pointing to the IHME GBD study for several reasons: it's widely recognized, easy to interact with, has a largely consistent / common methodology between different causes of death and disease, and importantly doesn't allow for deaths to be attributed to more than one cause. This works well for problems where the Open Philanthropy way of conceptualizing the problem (e.g. malaria, lead exposure) matches a GBD cause (e.g. malaria) or risk (e.g. lead exposure). This doesn't mean we uncritically use the GBD in all of our own decision making - but this set of reasons make it very helpful to refer to when communicating externally. It might be that we publish more of our internal research on this in the future, but honestly it's a serious time investment and I don't want to over promise. 

DALYs sit behind the framework but can be understandably offputting for many audiences. The BOTECs / grant decisions are in line with our usual GHW cause prioritization framework of valuing increases in healthy life and log-income.

The $5-10M figure is inclusive of $5M per year from that grant, which was recommended by GiveWell but funded by Open Philanthropy.

The $5-10M for alcohol work is indeed LMIC only - GiveWell document from 2021 here. I think the main funder missed from that is the DG Murray Trust in South Africa, whose alcohol harms reduction work is exclusively South Africa oriented.

There isn't a development assistance for health estimate from the IHME for alcohol policy work, lead exposure, or suicide prevention through means restriction in the way that there is for tobacco. One reason for displaying these funding estimates as a range is that they are very uncertain and vulnerable to questions of what gets included or not. 

There is some HIC alcohol policy funding. I'd personally be leery of including Drinkaware, since it is funded by alcoholic beverage manufacturers (and some other broader industry participants) and so I think sits in quite a different category.

Yes, we do consider the benefits of alcohol, including that many people enjoy it. 

James Snowden put together a short document discussing this when he made the largest current Open Philanthropy alcohol grant in 2021 (the grant was recommended by GiveWell but funded by Open Philanthropy; any extension / renewal will sit within Open Philanthropy). At the time GiveWell / James applied a 10% reduction to the (implicitly net) burden of alcohol harm on this basis.

I'm reviewing this issue in greater detail now.

Thanks for sharing! I occasionally worry that I'd struggle emotionally to go back to E2G/most of my impact being via donations, so this is a helpful anecdatum.

Answer by ChrisSmith18

In the spirit of quick answers, yes

R21 is good, the case for going faster is ethically strong and is pretty well articulated already, making this a relatively easy lift. Concerns around relative cost effectiveness vs other malaria control measures (e.g. bednets, SMC) are reasonable questions to raise but largely irrelevant for this given the proposal is to accelerate something that will happen anyway, the funding for delivering a malaria vaccine is largely secured already (via Gavi, Global Fund, national governments) and is unlikely to meaningfully funge more cost-effective alternatives. R21 is much cheaper than RTS,S, and almost certainly more effective.

It does not. There are a small number of co-funding situations where money from other donors might flow through Open Philanthropy operated mechanisms, but it isn't broadly possible to donate to Open Philanthropy itself (either for opex or regranting).

This comment is an agree vote for Client Earth and a disagree vote for anyone arguing the case for endocrine disruptors as an issue that EAs should spend lots of time or money on

Jerusalem Demsas, staff writer at the Atlantic focused on housing and infrastructure development and visiting Fellow at Center for Economy and Society.  

Good to interview on YIMBY movement and American infrastructure.

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