Children Are Dying Whom You Can Save

Crossposted from my blog.  

It is a sin to despise one’s neighbor, but blessed is the one who is kind to the needy.

—Proverbs 14:21

(I think this is a very important article, so I’d appreciate if you could share it! If anyone sets up an annual donation of at least 50 dollars a month to Givewell top charities in response to this article, they’ll be given a free paid subscription).

About 450,000 children die a year of malaria, more than 1,000 a day. Three entire plane-loads worth of innocent children are being exterminated every single day by a disease that is easily within our power to cure. If some group was systematically exterminating 1,000 children every day, everyone would recognize it as a serious moral emergency. But in the case of malaria, our enemy is not a human group but a disease. We fight a foe without a face, our most ancient enemy, one which is far more insidious and lethal than war. Yet because its victims are far away—they cry out in distant hospital beds in desperately poor villages—we mostly ignore it.

It costs about 4,500 dollars to save a life if you give to the Against Malaria Foundation or the Malaria Consortium. Experts have found these to be the most statistically cost-effective charities for improving lives at minimal cost. If you’re concerned about insect suffering, those 4,500 dollars also prevent about 63 million years of insect suffering, totaling around 2 billion painful insect deaths averted.

If we can prevent something terrible from happening at comparatively minor cost, we ought to do so. While we can debate exactly how much morality demands of us, at the very least it is very good to save the lives of people who would otherwise die in misery, agony, and terror. The life of a child is of incalculable value.

Imagine some child in your life. Children are wonderful—cute, bubbly, adorable, rapidly figuring out the world. That person being snuffed out would be an unimaginable tragedy, a horror of epic proportions, the sort of crime that blackens the world and makes one question whether there is a God. But it is just as horrible for people on the other side of the world when their children die. Though we cannot hear their stories, their suffering and lost years of life are just as horrible.

So effective are the top Givewell charities that the one topping out the list—the Malaria Consortium—adds a year of life for every ~$150 spent. That means every penny spent adds two days of life. Surely a year of life is worth more than $150 and a day of happy life is worth spending more than fifty cents. We’d all spend $150 to give our loved ones another year of life.

We therefore have an opportunity to do huge amounts of good at minimal cost. It’s rare that you can literally save another person’s life for the cost of just a few thousand dollars! Regardless of whether we have stronger obligations to our loved ones than distant foreigners, at the very least, we have strong moral reasons to prevent terrible things from happening to foreigners at small personal cost. As C.S. Lewis writes:

I do not believe one can settle how much we ought to give. I am afraid the only safe rule is to give more than we can spare. In other words, if our expenditure on comforts, luxuries, amusements, etc., is up to the standard common among those with the same income as our own, we are probably giving away too little. If our charities do not at all pinch or hamper us, I should say they are too small. There ought to be things we should like to do and cannot do because our charities expenditure excludes them.

In other words, you don’t have to go overboard and accept the radical utilitarian view that one should give away all their money. Instead, I am only making a more modest claim: we have strong moral reasons to make giving at least one of the main enterprises in which we are engaged. If you earn the average income in the west, you’re one of the richest 1% of people currently alive. Surely the richest 1% should spare a few percent of their income to prevent toddlers and babies from choking to death on their own phlegm in a hospital bed.

It can be easy to underestimate the strength of our moral reasons to give money away because we are the people asked to give away money. People notoriously underestimate the convincingness of moral arguments when they make real demands. So instead, imagine things from the perspective of the people suffering. Imagine that your child was dying in a hospital bed, and the only way to cure her would be for some wealthy foreigners who make thousands of times more than you do, to give a few thousand dollars—far less than they routinely spend on vacations, cars, and other luxuries. It would seem manifestly obvious that they ought to spend the money saving your child’s life.

One helpful exercise for determining how to behave is imagining oneself behind a veil of ignorance that takes away your knowledge of which person you are. So, for instance, behind the veil of ignorance you would oppose Ted Bundy’s actions; if you were equally likely to be the victim of one of Bundy’s murders as the perpetrator, you obviously would not carry out the murder.

Similarly, however, if you did not know whether you were the child with malaria or the person considering giving money away to combat malaria, you would obviously support giving away money. If there was a 50% chance that giving away money would save your life, and a 50% chance that it would cause you to lose out on a few thousand dollars, you’d obviously support giving it away.

Our obligations do not get weaker to a person just because they are physically more distant from us. If you could press a button to save someone’s life, but pressing the button was a bit expensive, your moral reasons to press the button would not get weaker as you fly further away from them in a plane. In light of this fact, if you would save children from malaria at the cost of a few thousand dollars if they were right in front of you, so too should you if they’re distant.

If you’re a Christian, the case for giving to the poor is even clearer. Jesus told a man, “If you want to be perfect, go, sell your possessions and give to the poor, and you will have treasure in heaven. Then come, follow me.” In Luke, Jesus declares “Give, and it will be given to you. Good measure, pressed down, shaken together, running over, will be put into your lap. For with the measure you use it will be measured back to you.” And 1 John says “But if anyone has the world's goods and sees his brother in need, yet closes his heart against him, how does God's love abide in him?”

Jesus is quite clear on the importance of giving to the poor. He even says in Luke 14 “When you give a luncheon or dinner, do not invite your friends, your brothers or sisters, your relatives, or your rich neighbors; if you do, they may invite you back and so you will be repaid. ¹³ But when you give a banquet, invite the poor, the crippled, the lame, the blind, ¹⁴ and you will be blessed. Although they cannot repay you, you will be repaid at the resurrection of the righteous.”

He told people “So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.” But if you were poor, if your child was sick, you would want others to intervene and help. So too should you intervene to help the poor children whose lives you can save at the cost of just a few thousand dollars.

In fact, Jesus seemed to endorse other core tenets of effective giving. He urged effectiveness, telling people to “be shrewd as serpents and innocent as doves.” He repeatedly told people to love their neighbor, and even went so far as to clarify that one’s neighbor included foreigners in the parable of the Good Samaritan. And while the good Samaritan was near the person they helped, I doubt Jesus would think that’s relevant—presumably he would not say “however, if you are somewhat physically distant from the one suffering, then they are no longer their neighbor, and so you should ignore their interests.” He commanded: pray for those that persecute you. He notably did not say only pray for those who persecute you and are somewhat near to you.

So please, give some money to Givewell top charities. You can prevent unnecessary death, suffering, and disease—doing huge amounts of good with every dollar spent. Children are currently dying unnecessarily; you can prevent this at a cost that pales in comparison to the one that they will have to bear if you don’t act. In the 21st century, one can do far more good with their donations than in almost any other way. In light of this, take seriously the opportunity to do good that you’ve been given, and give some money to help the most destitute people on earth avoid a horrifying fate.