Thank you for writing this! I definitely see the appeal behind the entry example of the malaria vaccine, and behind much of the abundance medical reform agenda.
But when I listen to actual abundance discussions and policy asks, they mostly don't focus on that. Instead, they focus on housing, birth rates, and general economic growth, all in the richest countries on earth. The first-order effects of most of these are to slightly raise the quality of life for some of the most well-off beings on the entire planet. There are certainly exceptions, and there are plausible arguments that the second-order effects are very good, such as saving liberal democracies. But second-order effects are notoriously hard to evaluate, and many existing EA interventions can also claim beneficial second-order effects, in addition to their first-order effect of saving lives and reducing extreme suffering.
Not only are the benefits unclear, but there are also substantial risks. Abolishing regulation that seems pointless is all well and good until you realize that "regulation that seems pointless to most people" is a category that includes some of the highest moral priorities. For instance, many AI safety interventions are annoying barriers to growth, such as installing hardware-enabled mechanisms on chips or having to publish various reports and safety evaluations. In animal welfare, laws that require humane pesticides in agriculture or bird-proof glass could avoid extreme suffering for millions of animals at a trivial cost to humans.
I still tend to think abundance is net positive, but not a top priority for impartial altruists. Though, as I said, the 20% part about medicine seems great, and moving the abundance movement more in that direction could be a great opportunity for some people.
Thank you for writing and sharing this. I appreciated your previous books and have been very excited to read this ever since I learned about it. I have already begun my reading :)
Edit: I created a free audio version of the book, maybe somebody finds it useful!
Okay, thank you for helping fight it!