NickLaing
Bio
Participation1
I'm a doctor working towards the dream that every human will have access to high quality healthcare. I'm a medic and director of OneDay Health, which has launched 53 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.
How I can help others
Understanding the NGO industrial complex, and how aid really works (or doesn't) in Northern Uganda
Global health knowledge
Posts 24
Comments1569
Thanks @mal_graham🔸 this is super helpful and makes more sense now. I think it would make your argument far more complete if you put something like your third and fourth paragraphs here in your main article.
And no I'm personally not worried about interventions being ecologically inert.
As a side note its interesting that you aren't putting much effort into making interventions happen yet - my loose advice would be to get started trying some things. I get that you're trying to build a field, but to have real-world proof of this tractability it might be better to try something sooner rather than later? Otherwise it will remain theory. I'm not too fussed about arguing whether an intervention will be difficult or not - in general I think we are likely to underestimate how difficult an intervention might be.
Show me a couple of relatively easy wins (even small-ish ones) an I'll be right on board :).
Thanks this is super interesting and definitely concerning.
FWIW within the non-EA Global Health Community this has been a topic of conversation for the last 3-4 years. It is potential threat, but still seems like a super low percentage Xish-risk, because...
a) We haven't actually seen anything terribly dangerous happen yet
b) Antifungal medications are there, and if there was a super-dangerous-mass fungal threat I suspect we could make better ones pretty quicksmart. But yes this is far from guaranteed.
As a side note there are already plenty of pathogens we catch from the soil like anthrax and tetanus, as well as worms like hookworm!
I can attest that I message @Toby Tremlett🔹 quite a bit and he's always really nice, even when my suggestions are kind of stupid or a little emotional.
Actually he's polite and nice even when they're really stupid or extremely emotional as well.
I would ask myself something like these questions to figure this out, I'm assuming by the picture you paint that you don't think their current work is necessarily wildly impactful?
1. Do I have the time and headspace to take this on? Will it negatively affect other things I do
2. Do I like the other board members (at least in theory), and will I work well with them?
3. Will this be something energy giving and enjoyable for me? Some work (even if not that impactful) can almost paridoxically give us more energy for the more impactful stuff. I've noticed this more and more over the years.
4. Is there perhaps an opportunity for me to shape the charity's work towards something more impactful? Influencing the thought world of children has potential. There's a saying attributed to the Jesuits which goes something like "Give us a child till they are 7 and we'll have them for life", so those years are importantly formative.
Its an interesting question, but given that no "cure" for these diseases has ever really been found despite enormous pharma spends to find cures for these crippling illnesses which affect the rich almost as much as the poor, I think there's a strong argument that its not super neglected given big pharma has spent a lot already, and tractability here seems low without evidence of previous cures.
I don't think it makes sense to think of these these statements by big NGOs about "lives saved" in the same way as a GiveWell analysis. These numbers are often grossly overestimated often 10x or more. They don't do proper, rigorous cost-effectiveness analysis before making these statements. The CEO's of these huge orgs also can't be expected to understand cost-effectiveness analysis properly. Their job is to be public figureheads and to manage behemoth orgs, not to understand numbers deeply.
Also they say "Your ability to save 1.1 million lives is compromised" which is not exactly saying that extra money would translates to those lives saved. I'm also not clear exactly what they are trying to say, but it may be deliberately vague
My intuition would be that there is a low chance that Gavi's marginal cost per life saved with extra funding is cheap enough to clear GiveWell's cost-effectiveness bar. The first billion of their yearly budget ight be cost-effective, but for marginal extra dollars there are diminishing returns with vaccines, just like there are usually diminishing returns, including with initiatives like mosquito nets and corporate campaigns.
SPECIFIC Gavi programs or initiatives GAVI could be super cost-effective though and that might be worth looking into. An analogy might besprawling big NGOs like CHAI or PATH, which (IMO) do a huge amount of work which isn't cost-effective at all. But GiveWell funds some of their specific programs which might be more cost-effective.
Thanks for this reply - I agree with most of what you have written here.
I think though you've missed some of the biggest problems with this campaign.
1. This seems to undermine vegans and vegetarians (see image above), and their efforts to help animals. It seems straightforwardly fair to interpreted this as anti-veganuary and anti-vegan, especially at a glance.
2. What matters in media is how you are portrayed, not what the truth is. Your initial campaign poster is ambiguous enough that its easy to interpret as a pro meat-eating campaign and anti-vegan campaign. I could have interpreted it as that myself, I don't think the media were grossly wrong here to report that.
The Telegraph article is pretty good actually overall and makes good points that could be good for animal welfare, although the first "clickbaity" title and paragraph is unfortunate (see above)
Media lasts for a day, correcting it is the right thing to do but doesn't have much of an impact.
I can see what you are trying to do here, and its quite clever. I love most of your stuff, but this campaign seems like a mistake to me.
Thanks for the update, and the reasons for the name change make s lot of sense
Instinctively i don't love the new name. The word "coefficient" sounds mathsy/nerdy/complicated, while most people don't know what the word coefficient actually means. The reasoning behind the name does resonate through and i can understand the appeal.
But my instincts are probably wrong though if you've been working with an agency and the team likes it too.
All the best for the future Coefficient Giving!