Gavi's investment opportunity for 2026-2030 says they expect to save 8 to 9 million lives, for which they would require a budget of at least $11.9 billion[1]. Unfortunately, Gavi only raised $9 billion, so they have to make some cuts to their plans[2]. And you really can't reduce spending by $3 billion without making some life-or-death decisions.
Gavi's CEO has said that "for every $1.5 billion less, your ability to save 1.1 million lives is compromised"[3]. This would equal a marginal cost of $1,607 per life saved, which seems a bit low to me. But I think there is a good chance Gavi's marginal cost per life saved is still cheap enough to clear GiveWell's cost-effectiveness bar. GiveWell hasn't made grants to Gavi, though. Why?
Indoor tanning is really bad for people's health; it significantly increases one's risk of getting skin cancer.[1] Many countries already outlaw minors from visiting indoor tanning salons. However, surprisingly, there are only two countries, Australia and Brazil, that have banned indoor tanning for adults, too. I think that doing policy advocacy for a complete ban on indoor tanning in countries around the world has the potential to be a highly cost-effective global health intervention. Indoor tanning ban policy advocacy seems to check all three boxes of the ITN framework: it is highly neglected; it affects many people (indoor tanning is surprisingly popular: over 10 percent of adults around the world have tanned indoors[2]), and thus has the potential to have a big impact; and also, I think it could be quite tractable (passing laws is never easy, but is should be doable, because the indoor tanning lobby appears to be much less powerful than, say, the tobacco or alcohol lobbies).
I'm initially skeptical on tractability -- at least of an outright ban, although maybe I am applying too much of a US perspective. Presumably most adults who indulge in indoor tanning know that it's bad for you. There's no clear addictive process (e.g., smoking), third-party harms (e.g., alcohol), or difficulty avoiding the harm -- factors which mitigate the paternalism objection when bans or restrictions on other dangerous activities are proposed.
Moreover, slightly less than half of US states even ban all minors from using tanning beds, and society is more willing to support paternalistic bans for minors. That makes me question how politically viable a ban for adults would be. "[T]he indoor tanning lobby" may not be very powerful, but it would be fighting for its very existence, and it would have the support of its consumers.
On the other side of the equation, the benefits don't strike me as obviously large in size. Most skin-cancer mortality comes from melanomas (8,430/year in the US), but if I am reading this correctly then only 6,200 of the 212,200 melanomas in the US each year are attributed to indoor tanning. The average five-year survival for melanoma in the US is 94%. So the number of lives saved may not be particularly high here.
Is indoor tanning worse than outdoor tanning? If not, I can see a ban making sense in cold countries, where people might counterfactually tan, but in countries like Australia and Brazil I can assure you this just has a displacement effect of sending people outside (even in winter).
Yes, indoor tanning is worse for your health than outdoor tanning. Indoor tanning beds beam UV radiation that can be as much as 10 to 15 times stronger than what you get from the sun.[1]
It is worth mentioning that people who use indoor tanning are also more likely to not use sun protection when outdoors[2]. This means that we really would not want to ban indoor tanning if the result is people just spending more time outside in the sun and getting the same dose of exposure. I did not find any studies that have looked at to what extent this is what people do after indoor tanning is banned.
My guess, though, is that a ban would be significantly net positive, even after accounting for a potential increase in outdoor tanning.
Gavi's investment opportunity for 2026-2030 says they expect to save 8 to 9 million lives, for which they would require a budget of at least $11.9 billion[1]. Unfortunately, Gavi only raised $9 billion, so they have to make some cuts to their plans[2]. And you really can't reduce spending by $3 billion without making some life-or-death decisions.
Gavi's CEO has said that "for every $1.5 billion less, your ability to save 1.1 million lives is compromised"[3]. This would equal a marginal cost of $1,607 per life saved, which seems a bit low to me. But I think there is a good chance Gavi's marginal cost per life saved is still cheap enough to clear GiveWell's cost-effectiveness bar. GiveWell hasn't made grants to Gavi, though. Why?
https://www.gavi.org/sites/default/files/investing/funding/resource-mobilisation/Gavi-Investment-Opportunity-2026-2030.pdf, pp. 20 & 43 ↩︎
https://www.devex.com/news/gavi-s-board-tasked-with-strategy-shift-in-light-of-3b-funding-gap-110595 ↩︎
https://www.nature.com/articles/d41586-025-02270-x ↩︎
Indoor tanning is really bad for people's health; it significantly increases one's risk of getting skin cancer.[1] Many countries already outlaw minors from visiting indoor tanning salons. However, surprisingly, there are only two countries, Australia and Brazil, that have banned indoor tanning for adults, too. I think that doing policy advocacy for a complete ban on indoor tanning in countries around the world has the potential to be a highly cost-effective global health intervention. Indoor tanning ban policy advocacy seems to check all three boxes of the ITN framework: it is highly neglected; it affects many people (indoor tanning is surprisingly popular: over 10 percent of adults around the world have tanned indoors[2]), and thus has the potential to have a big impact; and also, I think it could be quite tractable (passing laws is never easy, but is should be doable, because the indoor tanning lobby appears to be much less powerful than, say, the tobacco or alcohol lobbies).
https://www.aad.org/public/diseases/skin-cancer/surprising-facts-about-indoor-tanning ↩︎
https://www.aad.org/media/stats-indoor-tanning ↩︎
I'm initially skeptical on tractability -- at least of an outright ban, although maybe I am applying too much of a US perspective. Presumably most adults who indulge in indoor tanning know that it's bad for you. There's no clear addictive process (e.g., smoking), third-party harms (e.g., alcohol), or difficulty avoiding the harm -- factors which mitigate the paternalism objection when bans or restrictions on other dangerous activities are proposed.
Moreover, slightly less than half of US states even ban all minors from using tanning beds, and society is more willing to support paternalistic bans for minors. That makes me question how politically viable a ban for adults would be. "[T]he indoor tanning lobby" may not be very powerful, but it would be fighting for its very existence, and it would have the support of its consumers.
On the other side of the equation, the benefits don't strike me as obviously large in size. Most skin-cancer mortality comes from melanomas (8,430/year in the US), but if I am reading this correctly then only 6,200 of the 212,200 melanomas in the US each year are attributed to indoor tanning. The average five-year survival for melanoma in the US is 94%. So the number of lives saved may not be particularly high here.
Yeah, it looks like the impact is probably not that big, if compared to say lives that could be saved via alcohol or tobacco control policy advocacy.
Is indoor tanning worse than outdoor tanning? If not, I can see a ban making sense in cold countries, where people might counterfactually tan, but in countries like Australia and Brazil I can assure you this just has a displacement effect of sending people outside (even in winter).
Yes, indoor tanning is worse for your health than outdoor tanning. Indoor tanning beds beam UV radiation that can be as much as 10 to 15 times stronger than what you get from the sun.[1]
It is worth mentioning that people who use indoor tanning are also more likely to not use sun protection when outdoors[2]. This means that we really would not want to ban indoor tanning if the result is people just spending more time outside in the sun and getting the same dose of exposure. I did not find any studies that have looked at to what extent this is what people do after indoor tanning is banned.
My guess, though, is that a ban would be significantly net positive, even after accounting for a potential increase in outdoor tanning.
https://www.npr.org/sections/shots-health-news/2025/12/14/nx-s1-5640088/tanning-bed-users-are-at-higher-risk-of-skin-cancer-especially-in-unusual-places ↩︎
https://jamanetwork.com/journals/jamadermatology/fullarticle/2565799 ↩︎