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You take the number of expected years of life left and you multiply it by this pretty subjective factor, which accounts for… does this person have cognitive function? Can they make plans? Are they a functioning agent in the world? You multiply those two things together and end up with a roughly log-normal distribution over age.

James Snowden

What’s the value of preventing the death of a 5-year-old child, compared to a 20-year-old, or an 80-year-old?

The global health community has generally regarded the value as proportional to the number of health-adjusted life-years the person has remaining – but GiveWell, one of the world’s foremost charity evaluators, no longer uses that approach. They found that contrary to the years-remaining’ method, many of their staff actually value preventing the death of an adult more than preventing the death of a young child. But there’s plenty of disagreement, with the team’s estimates spanning a four-fold range.

As James Snowden – a research consultant at GiveWell – explains in this episode, there’s no way around making these controversial judgement calls based on limited information. If you try to ignore a question like this, you just implicitly take an unreflective stance on it instead. And for each charity they investigate there’s 1 or 2 dozen of these highly uncertain parameters that need to be estimated.

GiveWell has been working to find the best way to make these decisions since its inception in 2007. Lives hang in the balance, so they want their staff to say what they really believe and bring whatever private knowledge they have to the table, rather than just defer to their managers, or an imaginary consensus.

Their strategy is to have a massive spreadsheet that lists dozens of things they need to know, and to ask every staff member to give a figure and justification. Then once a year, the GiveWell team gets together to identify what they really disagree about and think through what evidence it would take to change their minds.

Often the people who have the greatest familiarity with a particular intervention are the ones who drive the decision, as others choose to defer to them. But the group can also end up with very different answers, based on different prior beliefs about moral issues and how the world works. In that case then use the median of everyone’s best guess to make their key decisions.

In making his estimate of the relative badness of dying at different ages, James specifically considered two factors: how many years of life do you lose, and how much interest do you have in those future years? Currently, James believes that the worst time for a person to die is around 8 years of age.

We discuss his experiences with doing such calculations, as well as various other topics:

  • Why GiveWell’s recommendations have changed more than it looks.
  • What are the biggest research priorities for GiveWell at the moment?
  • How do you take into account the long-term knock-on effects from interventions?
  • If GiveWell’s advice were going to end up being very different in a couple years’ time, how might that happen?
  • Are there any charities that James thinks are really cost-effective which GiveWell hasn’t funded yet?
  • How does domestic government spending in the developing world compare to effective charities?
  • What are the main challenges with policy related interventions?
  • What are the main uncertainties around interventions to reduce pesticide suicide? Are there any other mental health interventions you’re looking at?
  • How much time do you spend trying to discover novel interventions?

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The 80,000 Hours podcast is produced by Keiran Harris.


I think there’s a question, there’s a really high-level question about whose values should we be using. One, you might think the beneficiaries are the values we should care about. Secondly, maybe our staff are the best people to be making these decisions. Thirdly, our donors. Fourthly, maybe some idealized consensus of all people or what do other major prioritization organizations, or how did the World Health Organization make this trade-off? That kind of thing.

At the moment we do it for our own staff, but trying to take into account these various other data points. We have asked our donors, we’ve surveyed a few of our donors and generally got the impression that most people just don’t have numbers in mind, which is consistent with my understanding of how people think. Not many people are walking around with this figure in their mind of how they would value preventing a death compared to increasing somebody’s consumption.

I think something that would push you in the direction of GiveWell charities over other options would be if you think there’s this kind of trade off, where we think that the short term effects of an intervention, which we might be able to make a pretty well-evidenced guess about, are a pretty decent proxy for the overall effectiveness of an intervention. I think that certainly doesn’t apply in all cases, but when you’re thinking about these very difficult to estimate effects, you’re making this trade off here between having to make judgment calls based on very limited evidence, versus potentially the kind of long run effects being the most important thing. And so we see our role largely as using these short term effects as a proxy for what we think might be best in the long run.

So we might think, well, okay, here is this change that was made in government policy in India, say, a couple of years ago, and we’ll ask the charity, do you think that a lot of your value came from influencing this change? Then we have to piece together, it’s interesting, it’s a bit more like investigative journalism than maybe the traditional work we’re doing. We’re just trying to piece together from different sources, okay, what are the other causal strands that could have played a role here, how important was this actor relative to other actors, and sometimes it’s very difficult to tease these apart.

But at least some narratives we can kind of, they seem a lot more plausible to us. And then we can test those narratives by talking to other people who were involved, and think, well, is there a consistent story here that does seem to draw a plausible causal pathway between the actions of this charity, and this particular policy change coming into effect? And then the other part of that of course is, how good was this policy? And that looks a lot more like our traditional work.

If you’re causing other actors to spend their funds on something more valuable than they otherwise would have, that should be a good thing, and we think that’s something that charities should be rewarded for. On the flip side, if we thought that without the Against Malaria Foundation these anti-malarial bed nets would be fully distributed by the country governments, that seems like something we’d want to penalize AMF for.

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The 80,000 Hours Podcast features unusually in-depth conversations about the world's most pressing problems and how you can use your career to solve them. We invite guests pursuing a wide range of career paths — from academics and activists to entrepreneurs and policymakers — to analyse the case for and against working on different issues and which approaches are best for solving them.

The 80,000 Hours Podcast is produced and edited by Keiran Harris. Get in touch with feedback or guest suggestions by emailing [email protected].

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