I am at the conference now so voice recorded this and used an LLM to clean up prose. N.B. wrote this in <30 min so it is very rough--but I thought speed was more relevant than polish given timeliness of the conference happening now
Lewis Bollard opened EAG London with the first social reform movement: abolitionism. He touched on others too, including Henry Spira bringing McDonald's to the table instead of demanding they stop serving meat. His argument: the through-line from them to EA is three virtues (altruism, radical empathy, and ambitious pragmatism). On the latter, the original abolitionists choosing the slave trade over slavery because it was winnable. Compromise as the price of victory.
I've spent my career in movements and systems change: getting community health workers salaried and accredited as national policy, the unglamorous machinery of #HealthforAll. This looks like approaching a problem by asking what conditions are holding the problem in place and changing them. i.e. Playing general manager for a whole problem, the way Lewis does for ending factory farming. I really, really dug his talk.
It also confused me. Because what he celebrated is not what I understood EA to be. From the outside (this is my first EAG), EA comes off as cost-per-outcome driven, and (particularly in GHD) a this manifests as huge emphasis on direct delivery: i.e. the bednet, not the movement that makes governments guarantee the right to health. Lewis spent his talk on scale, system change, and narrative reform, whereas my impression was that the question EA is obsessed with is the measurable marginal dollar, not the big system bet.
Relatedly, what struck me most in my first 12 hours @ EAG is EA clearly does believe in movement-building in the sense thatit spends an enormous amount on its own! EAG, 80,000 Hours, the fellowships, the community-building grants, this whole beautifully run machine (thank you, swapcard). So the conviction is there but it just seems to (largely) run inward, toward growing EA, rather than outward, toward funding the kind of movements Lewis spent 25 minutes admiring.
I may be wrong about my sense of mismatch and I'd like to be. Who here works on scale, systems change, narrative reform (esp in health delivery)? Am curious about those who have made the “GM for an entire problem” approach legible within EA rather than optimizing one slice of it.
Hi Madeleine!
Thank you for your post and for bringing up this topic! I am interested in systems change and I can probably give you some hints about what is being done there. I think there are many people in EA who are interested in systems change. I was a co-author to a forum post about systems change. There are EA groups that are interested in systems change as well. I do not “work” on systems change, but I volunteer in that field, so I am up for it! Lead Exposure Elimination Project is probably the best example. But we also have some EA organisations focusing on policies in fields like alcohol, tobacco, soda, sodium and also Global Policy Research Group. I am not sure if everything I list here is what you are looking for, but I will make a summary about each organisation.
I would say that One Day Health is a promising organisation since they are creating primary health care in a cost-effective way to fill in health delivery gaps. But I don’t know about “systems change” in that case. But I think it is quite a small step to systems change in that case.
Essential Emergency and Critical Care has a similar approach but focuses on critically ill patients. They have a Government led national programme, and they are cost-effective.
I know that State of Life made an impact report about Tearfund who is a Christian charity that mobilises churches for community transformation. I think they are quite cost-effective even if they are not EA.
Teaching at the Right Level Africa is one of the world's most cost-effective programs for increasing children's ability in mathematics, language, and literacy and it is promoted by The Life You Can Save. The program is used in over 18 countries, of which 17 are in Africa, reaching 7 million children, and one is India, reaching 76 million children. There are many other programmes at The Life You Can Save that might be into systems change.
We have multilayered programmes like Breakthrough Trust, which is a top charity according to The Life You Can Save. Breakthrough Trust combats violence against women and girls in India and creates changes in attitudes. The program works on several levels:
Strategic Alliance for a Viable Earth is an organization that matches experts with people in power so they make better decisions in various global problem areas. They have the same idea as you, about right people at the right moment, but they focus mostly on tipping points at the moment.
Cool Earth was a top charity before but not now. They support local and indigenous peoples to protect rainforests and combat the climate crisis. They use basic income for nature and climate - which means giving basic income to communities that protect rainforests and help them in different ways to empower these communities and save the rainforests.
Equal Right has the same approach as Cool Earth but also promotes a global basic income, global carbon tax, cap and share policy and global wealth tax. They are testing their ideas at the national level in countries with small populations. Their CEO knows what EA is but thinks systems change is better.
There are also organisations like the Social Change Lab that is EA-aligned and does research about social change and Initiative for Safeguarding Democracy that tries to find the best ways to protect democracy. There are organisations working on task-sharing in the field of global mental health. Strongminds, Friendship Bench and Vida Plena are some examples of this. Even if they are focused on direct delivery, task-sharing and their aim to make it part of national programmes might be helpful.
Other organisations that might be interesting but are not connected to EA (as far as I know) but focus on systems change are Odyssean Institute, Club of Rome, Earth4All and Global Commons Alliance.
I hope my comment is helpful! You are warmly welcome to DM me if you have further questions!
I’d like to point out that all EA programs working on common neglected diseases are pushing systemic change.
One of the most cited Acemoglu theories of economic development gives evidence that rates of settler mortality were much higher in some areas due to things like Malaria & that this encouraged the development of extractive colonialist institutions, whereas the places with lower settler mortality saw more people move to those places to live long term & develop inclusive institutions that increase growth & wellbeing.
Hey Madeleine! Good question. You might want to change the title to make it more descriptive, i.e. something like "Which EA organisations are working on systemic change?".
PS- the answer is lots. LEEP gets governments to enforce laws around lead in paint and food, Legal Impact for Chickens is trying to change how laws are applied (as is THL UK), Pause AI routes through a mass movement, etc...
When you get into it, the distinction between 'systemic change' and 'measurable intervention' is a spectrum rather than a binary. There are EA interventions at most points along that spectrum.
Appreciate it, Toby. Have done so! Thanks for the LEEP rec. My outside impression was that the gravity pulls hard toward the measurable end over the further-out bets (mass movements, narrative, constituency-building). Am curious who is thinking about health delivery policy change and welcome all such leads.
Would also love to explore the spectrum idea. My sense is there a) are a couple of axes that correlate: how upstream the lever is (service delivery → rules → institutions) and how easily you can measure and attribute the result (measurable/attributable → diffuse/long-horizon). B) That the distribution is lopsided…but I am interested in outliers! Particularly for reasons of scale and/or permanent norm change (à la abolition example)
Does Pause AI consider itself EA though?
That's reasonable, I have no idea. Definitely a fellow traveller though (they come to the conferences, work from the offices, etc...).
I'm sure there are many more examples of what I'm pointing at here that are closer to 'EA'.