Too narrow?

I'm always interested to see what people criticize about the effective altruism movement. One critique I noticed lately is that we're too narrowly focused on a few interventions and instantly reject anything that doesn't have a GiveWell stamp of approval. There's some truth to that.

A related critique is, “If everyone focused so narrowly, virtually nothing would get done – no art, no civic projects, just mosquito nets all the time."

(The art thing is especially touchy. Every time someone from the effective altruist movement suggests that symphonies and museums might not be the best charitable causes, people freak out about how we hate the arts.  I'd like to invite them to see Robbie's photography, hear Ray's music, go to one of Catriona's Shakespeare productions, or talk architecture with Toby.)

While I'm thrilled to see more people interested in effectiveness, I don't see such a stampede to effective causes that I think we're about to fund all the best giving opportunities.  If that ever happens, I have no doubt that most effective altruist types will move on to whatever cause seems next best.  For example, smallpox was a huge problem well into the 20th century.  But now that vaccination has been so successful, people have moved on to other causes.

Aside from the fact that effective altruists will move on to next-best projects after the best ones are taken care of, I'm not concerned that a narrow focus will mean that all non-optimal causes get neglected. Even those of us who focus on finding effective causes don't spend all our time and money on them.  I spend my days as a mental health clinician for prisoners. I am about to start the (possibly even more emotionally intense) work of parenting.  I don't do those things because I think they're the most effective ways to improve the world – I do them because I want to, because I find them satisfying.  But at the end of the day, I want to give my earnings to the most effective organization I can find. And it annoys me when people categorize me as some kind of heartless utility-bot because of that.

If you're upset that effective altruist types don't seem concerned about some issue in your local community, the problem might not be that we're too narrow-minded.  In fact, one of us may well have a day job in that field, or have a special place in our heart for spending our Saturdays working against water pollution or homelessness or whatever.

But that's not the same as saying, "My pet cause is so important and has so much opportunity for change that everyone should drop what they're doing and work on this."  I have a special place in my heart for refugee services, and I've volunteered in that field for years.  But I don't think it's the best thing everyone should be doing, and I'm not saying it should get top billing as an effective cause.

Meanwhile, I think interventions like deworming, nutritional supplementation, and malaria prevention really do deserve top billing.  Some of my money and time will still go to other areas, but I will prioritize the causes that have been demonstrated most effective.

Sometimes it's good to narrow things down.

Deciding where to give

I kept delaying writing this post because I'm not entirely sure where I'm donating over the coming year. I tend to spread donations out throughout the year, so I don't feel a particular rush in December. But, since the end of the tax year is a lot of people's giving season, I want to share my thoughts.

My previous favorite, the Against Malaria Foundation, is not looking so good lately due to problems distributing their mosquito nets. I'm not super concerned about this – I think it's likely that they'll get their act together in the next six months or so and resume distributing nets. But I don't plan to donate to them until that happens. (This is the kind of thing I'm really glad GiveWell is here to tell me about – as a donor, I would never have picked up on the problem.)

My parents usually make a donation as a Christmas present to me, and they asked where they should make it.  I asked them to give to Give Directly.  I think the just-give-cash method makes a lot of sense, given the evidence that recipients choose quite well what they need, and I hope this idea will catch on.  The organization itself seems quite transparent and sensibly run.  I also found it encouraging that so many GiveWell staff are making their personal donations there.

I can see advantages to donating later, especially given the fact that the Against Malaria Foundation (which looked like the strongest contender for a good while) may catch up again soon.  So I'll probably hold most of my donations for about six months and see how things look then.

If I were holding off longer, like years, I would probably put my donations in a donor-advised fund like GiveWell's or Giving What We Can's.

I also plan to donate some to organizations like GiveWell, Giving What We Can, or 80,000 Hours (I haven't decided on the breakdown yet).  I think this is an important time both for exposing more people to the idea of effective altruism and for developing better knowledge about where to give.  I need to look more specifically into what those organizations would do with more funding.

Lastly, I'll make some feel-good donations to causes that aren't the most effective (a fundraiser for a friend's business, my Quaker meeting, etc.) These donations come out of my personal spending budget, not my charity budget.

One obvious question is: why divide up money rather than giving all to one place? Giving What We Can makes some good points in their recent post about why to donate all to one charity.  But I'm also persuaded that we should act how we want other people to act, and I wouldn't want the whole effective altruist community to donate to only one place.  So I'm okay with dividing things up a bit.

669 lives

In 1938, a British stockbroker named Nicholas Winton was about to go on skiing vacation in Switzerland when a friend asked him to come to Prague instead. He arrived at a Czech refugee camp instead of his planned ski trip. The camp was filled with Jewish families trying to escape before the Germans arrived. In Winton's words, “I felt compelled to do something.”

He spent the next nine months using his money and organizational skills to arrange for hundreds of children to be evacuated by train and fostered by British families. He was 29 years old. He saved 669 children that year.  And afterwards, he didn't tell anyone what he had done.

50 years later, his wife discovered his journals in a briefcase in the attic. The children's names were in a scrapbook he had kept.  Here's footage of Winton realizing he's sitting next to dozens of the now-grown children:

We talk about “lives saved.” Mentally, I know that this year my donations will save several people's lives, and keep many more from getting sick. But it's so different to actually see those people assembled in a room.

Winton is still alive at age 104, and the children he saved are themselves old. One became a member of Parliament, another a groundbreaking geneticist, another a journalist and author. And most of them went on to do nothing especially remarkable except grow up, go to school, work, get married, have children, and generally do the things people enjoy doing when they don't die at age 6.

Recently someone asked me if it wasn't rather limiting, not getting to do as much travel as I might if I didn't donate. It's hard to imagine that Nicholas Winton regrets giving up his ski trip.

But what will my friends think?

This week I talked to some students about what life is like for my husband and me as people who give away a lot of our income.  Some of them seemed worried about the social consequences: what happens when your friends all have expensive houses and cars? Won't you feel left out? Won't people think you're strange?

I don't remember exactly what my answer was at the time, but here are some better-thought-out ones:

A lot of our friends are also on small budgets.
The bartender? The grad student? The novelist? The one whose job you can't really describe, but it involves postmodernism?  They're not rolling in cash. Unless you actually reach a point when all your friends are corporate lawyers, you probably won't be the only one living frugally.

A lot of our friends are a little weird, too.
We have a friend who commutes to work by unicycle. Another friend believes bacon is a health food and eats it in according quantities. Another friend is a professional blacksmith. Maybe it's just living in the neighborhood of Cambridge, MA, but there are a lot of eccentric people around. I don't mind being one of them.

You can have fun with your friends for cheap.  

• A lot of our friends are from the folk dance scene.  It doesn't cost much money, and participants tend to come from a wide variety of income levels.  It's not that easy to pick out who's a psychiatrist and who's an art teacher.  
• I enjoy cooking, so we often have people over for dinner rather than going to a restaurant.  
• Jeff and two of his college roommates have a standard arrangement whenever their wives are out of town: the bachelor-for-a-day invites the others over, and they play board games their wives don't like.  

Your friends aren't always into conspicuous consumption.
Jeff works as a computer programmer, and in his thrift-store work clothes he actually looks less scruffy than most of his coworkers.

There are lots of metrics to compare people on.
I have a partner I love. My parents are alive and healthy. I have all my teeth. There are lots of ways you can compare yourself to other people  — you'll come out ahead on some, and behind on some. That's true no matter your income.

Some of your friends will follow you.
We've heard friend say they admire us for following our principles.  And some of them say they've changed because of us — looking for more effective charities, giving more, or asking people to donate instead of giving them birthday presents.  I love hearing that.

We've met some awesome people through giving.
Since we started meeting other people who are interested in effective altruism, we've really clicked with some of them. After college I missed being able to talk ideas with people, and effective altruism has brought that back into my life.  (The downside: you have to get over your stage fright about talking to people with impressive credentials. It turns out most of them are regular people.)

Book review: Reinventing Philanthropy

Eric Friedman's book Reinventing Philanthropy: A Framework for More Effective Giving came out this month.

The book opens with an example that I find particularly compelling. Friedman gives the example of two sick children, one who received world-class care at an American children's hospital, and the other who perished for lack of basic care at an underfunded clinic in Angola. Both healthcare facilities are “good causes,” and donors might feel proud of supporting either one. But one is funded to the tune of millions of dollars a day, and the other lacks basic supplies. Rather than patting themselves on the back for supporting the state-of-the-art American hospital, Friedman suggests donors should consider funding the Angolan clinic that would be able to save far more children with the same money.

The book emphasizes the difference between giving to feel good and giving to do good (or, as he calls it, the “do-gooder approach” and the “do-bester approach.”) He argues that too much charitable giving is focused on making the donor feel good, regardless of what their money is actually accomplishing. But he proposes that it's possible to have both – to choose effective giving strategies while feeling the warm glow of knowing you helped others the best you could.

I'm sure there are donors out there who will not be persuaded by Friedman's approach – if their mother had Parkinson's, they will devote their charitable giving to Parkinson's research. In fact, the whole industry of charitable fundraising is built around this type of donor preference – show the donor giving opportunities within their chosen area of interest, but don't suggest that they consider some other area, even if they could help more people elsewhere.

But I think others will be compelled by Friedman's questions: what are you actually trying to combat? Is it Parkinson's disease in particular? Is it grief at watching a loved one grow ill and die? Is it human suffering in general? And if what you actually care about is preventing human suffering, shouldn't you fund whatever cause will best accomplish that goal?

Reinventing Philanthropy also provides sections on choosing charities to donate to, choosing whether to restrict your donation to a particular fund within a charity, and choosing to fund innovation vs. proven approaches. It also touches on ways to use your time to help, whether that's working or volunteering for a nonprofit, choosing a career that lets you donate more, or just talking to other people about how you make giving decisions.

Parts of the book are aimed at donors giving substantial amounts of money – for example, those giving a few hundred dollars won't be able to meet with the leadership of nonprofits they are considering, as Friedman advises. But the book's principles are sound, regardless of how much you donate.  By putting in some thought and research, donors at any level can be "do-besters."

Why I'm glad other people will do research for me

Popovers are a little tricky to make, so when I want to bake them, there's only one cookbook I go to: Cook's Illustrated New Best Recipe. Unlike most cookbooks, which maybe test a recipe once or a few times, Cook's Illustrated goes through dozens of variations and puts them through a taste-test panel. Is a popover better with pastry flour or a higher-protein flour? Skim or whole milk? Should you leave the oven at a steady temperature or bump the temperature down after an initial blast of heat? Honestly, I'm not going to take the time to figure these things out on my own.  But I'm glad someone else did.

When Jeff and I were first trying to pick a charity to donate to, I spent a couple evenings browsing the internet. I found a charity that seemed to match our values and had a good reputation. I tried to find dirt on them and couldn't find anything significant. So for the next few years, we donated there.

But this was kind of the equivalent of developing your own popover recipe. You'll probably wind up with something pretty good. But someone giving the task 40 hours a week, year in and year out, is almost certainly going to do better.

Which is why I'm glad there are professional charity evaluators out there. I'm glad the J-PAL Poverty Action Labs and Innovations for Poverty Action exist to do impact evaluations on different interventions that might help people. I'm glad the Copenhagen Convention exists to advise policy makers on how to tackle the world's most important problems.  I'm glad GiveWell exists to recommend specific charities to donors. I'm glad the Cochrane Collaboration compiles the best evidence on health in a format I can (usually) understand. I'm glad that randomized controlled trials of interventions seem to be catching on more.

Food.com offers 179 popover recipes. By looking at them, I have no idea which ones are duds and which produce perfect, airy results. Most charity evaluation sites rank thousands of charities, also pretty inscrutable to a casual viewer. I don't want 179 recipes or thousands of charity ratings. I just want the best.

There's probably a better popover recipe out there. There are almost certainly better charities out there than the ones I know about, and better ones that could be invented. But in the amount of time I'm willing to give the task, I'm not going to find them. So I'm glad there are people smarter and more dedicated than I am whose job it is to work on these hard problems.

(Want a popover?  The recipe's here.  Eat them with butter and jam.)

Photo: Jeremy Noble [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Malaria, one-trick ponies, and lasting change

It's a summer afternoon, and I'm reading the latest debate about narrow vs. systemic charitable interventions.  Scratching a mosquito bite, I'm reminded of a public health intervention that took place in my own country.

When my grandparents were growing up, the American South was still plagued by malaria (or ague, as it was often called.)  And what was the effect of the disease?

“While there is good land in the Southern United States as in the North, the land in the North sells at about 12 to 20 times the price, the difference being mainly due to malaria.”  - Carter, 1922, quoted here

“The diseases due to all four species of malaria parasite share the characteristic febrile episodes with their tendency to regular periodic paroxyms with chills, rigors, and sweating. They also have many symptoms in common with other infectious illnesses, including body aches, headache and nausea, general weakness, and prostration. . . . Lethargic and with sunken and sallow features, spindly limbs, and hard swollen belly is the general description of the condition. In this state the affected individual succumbs to diseases or other hardships that would scarcely threaten a person in reasonable health.” - Carter and Mendis, Evolutionary and Historical Aspects of the Burden of Malaria

PAHO/WHO, December 1969

The disease had been lessening over the late 19th and early 20th centuries due to better housing (glass and screens for windows) and the use of quinine.  But in the 1940s, the government took matters into its own hands.

During World War II, troops were succumbing to malaria on bases in the Southern US.  The Office of Malaria Control in War Areas was founded in 1942 to protect the areas around military bases. After the war it became the Centers for Disease Control (the CDC) and took on the task of eliminating the disease from the entire nation.  By 1951, the disease was eradicated from the United States.

Woman in rural Georgia, 1941.  Note the wooden shutter - no glass or screen.

This is the type of intervention that I've often heard criticized for its narrow focus.  I've heard single-issue medical interventions called "one-trick ponies", "short-sighted", "kicking the can down the road."  And to be sure, the eradication of malaria in the US was a top-down intervention carried out by a government agency without much community involvement.  There was not an attempt to change the social and economic conditions that prevented people from buying their own windowscreens and DDT. It just dealt with actual disease transmission.

Instead of narrowly-focused efforts, proponents of broad social change advocate "lasting solutions," "systemic change," "a new operating system." Which is great when it happens. But if public health interventions are difficult to carry off well, systemic change is even harder.

And yet it does happen. Interestingly enough, the Civil Rights movement sprang up in the South just as malaria was ending. The newly-formed CDC, located in Atlanta to be near the most malarial areas, declared the disease eliminated from the United States in 1951. That same year Martin Luther King, Jr. graduated from seminary. American blacks still bore the burdens of political disenfranchisement, inadequate education, poor access to health services, violence, and daily acts of hate and humiliation. But they no longer ran the risk of illness or death with every mosquito bite.

Obviously there was a lot more to the Civil Rights movement than a lack of malaria. But it was one of the factors that helped. How likely is someone with “body aches, headache and nausea, general weakness, and prostration” to make it to the polls, to school, or to work? How likely are they to march on Washington?

It's easier to dream big from behind a windowscreen. Easier when you're not hungry. When you're not sick.  When you're not weakened from parasites and malnutrition.  And for those of us who would love to see systemic change, the "one-trick ponies" may be a good way forward.