Sebastian Farquhar

Why averting a DALY through deworming may be better than through malaria nets

This is the summary of an article by the Global Priorities Project. You can read the whole article 

Global public health remains a top contender for the best way to improve welfare through aid. Within health interventions, it is natural to allocate marginal spending to avert the most expected DALYs (disability adjusted life-years) per dollar.[1]

However, not all DALYs are the same and there are important differences between years of life lost (YLLs) and years lived with disability (YLDs). Not accounting for these categories separately may introduce a bias in decision-making because DALYs do not address non-health outcomes for individuals and the effects of outcomes on others. These effects are different in situations which involve primarily YLLs as opposed to YLDs. This analysis is of particular practical importance to effective altruists because two of the most promising interventions address different types of DALYS – deworming primarily averts YLDs and bed nets to prevent malaria primarily avert YLLs.[2] This make us more inclined towards deworming as a top intervention than a naive evaluation would suggest. More sophisticated analyses incorporate terms that address many of these effects, but may still undervalue deworming relative to malaria nets.

This document is primarily written for people who already place a high weight on DALYs in identifying top public health opportunities. It does not argue for the use of DALYs, or consequentialist reasoning in identifying public health opportunities.

For example, a simple reading of the work of the 

 2nd edition, suggests such an approach. Some evaluators, such as 

, place much less emphasis on averting DALYs.

Christmas gifts, goats and cash-transfer charities

It’s getting closer to Christmas, and we’re running out of time to get presents for friends and family. It can be hard to work out what presents people will actually enjoy. An increasingly popular option is to make a donation on behalf of someone else as a present.

When it comes to presents, it seems like a thoughtful gift is better than a gift certificate, and a gift certificate is better than a thoughtless gift. It’s a lot like that for charity gifts too. Your best options are likely to be donations towards 

. And in last place will be the unasked for gift of a goat.

What was originally a fairly uninspired set of options for charity gifts has since turned into a wide range of charitable choices for the holidays. Oxfam alone lets you select gifts from 

But the old stand-by is sending farm animals to developing countries. This seems unlikely to be motivated by effectiveness. I googled “Give a _____ for christmas” for a bunch of farm animals and wrote down the estimated number of search results.

Now, it’s possible that goats are just much much more valuable to rural people living in developing countries than any other sort of animal. Alternatively, it’s possible that the alliteration of “g” in “Give a goat” makes for catchier headlines. I don’t know for sure, but I have my suspicions.

There are also some decent reasons to think, as 

donations of livestock might be a particularly ineffective way to help the developing world.

 They seem to be quite a lot like cash transfers, but with a bunch of extra question marks.

(which is currently GiveWell’s second recommended charity after AMF)

 you empower people to make a decision about what they want most and buy it. That is, cash transfers are like the gift certificate of the charity world.

There are some real problems with cash transfers. For example they can lead to resentment and arguments when some people receive the transfer and others don’t or have distorting effects on local economies.

But with animals you lose most of the benefit of cash-transfers - you’re just deciding for people what you think they’ll want. You also avoid many of the benefits of the best non-cash transfer charities. Buying someone a goat for Christmas is like getting someone chocolate. You didn’t ask them what they wanted, you don’t really know them too well personally, so you just got the first thing on the shelf that looked like a present. The difference is that chocolate won’t poop on your floor.

But that doesn’t mean we have to just cave in and do the charity equivalent of a gift certificate. What’s the analogue to a really nice thoughtful gift that suits someone perfectly?

It turns out, you can get a thoughtful gift and donate to the most effective charities at the same time! Giving What We Can has it all. 

 lets you make a donation to one of their top recommended charities.

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Sebastian Farquhar

Articles

Why averting a DALY through deworming may be better than through malaria nets

Christmas gifts, goats and cash-transfer charities