Founder of the Centre for Exploratory Altruism Research (CEARCH), a Charity Entrepreneurship-incubated organization doing cause prioritization research.
Once a civil servant, and then a consultant specializing in political, economic and policy research. Recovering PPEist who overdosed on meta-ethics.
I undersrand that it's fundamentally just harder to produce potassium than sodium, though economies of scale should see the price difference fall somewhat as demand for potassium chloride grow over time as a result of health consumers.
Thanks for the tag, Mathias and Spencer!
Hi Oscar, CEARCH recently put out a report on hypertension as a cause area: https://forum.effectivealtruism.org/posts/k7NjuGEKdRSrrJHmZ/deep-report-on-hypertension
(1) TLDR: We expect advocacy for top sodium control policies (particularly regulating food manufacturers to reduce the sodium content on processed food), so as to reduce the disease burden of hypertension/high blood pressure, to be at least 10x GiveWell cost-effectiveness.
(2) The scientific evidence on more salt = worse health outcomes (heart attacks, strokes etc) is rock solid. There was a controversy some years back on the "J-Curve" hypothesis, which was the idea that at low levels of sodium consumption, maybe it's bad to further reduce sodium intake because that actually worsens health outcomes (hence a J-curve with sodium consumption on the X-axis and adverse health events on the Y-axis). However, the current scientific consensus is that the initial studies purportedly showing this were faulty, with poor methodology (particularly in relying on imperfect measures of sodium levels, rather than like 24-hour urine samples). All the meta-analysis we've read in full (e.g. Aburto et al, Ettehad et al, Strazzullo et al) or checked the abstracts of basically back the idea of a sodium-blood pressure-cardiovascular disease relationship.
(3) On potassium replacement - it's definitely promising (in fact, since writing the report, I have been persuaded to use salt with like 33% potassium chloride when cooking). The issue is cost - it's just more expensive, and it's not as if you can force consumers to pay more. Which brings us back to the need for regulatory interventions (e.g. aforementioned reformulation of food) or fiscal interventions (e.g. taxing salt), paired with consumer education (e.g. nutrition labelling and mass media campaigns) and just governments changing the menus in public schools, hospitals and workplaces.
Hi Sebastian,
While it's just a search methodology and we haven't had the chance to brainstorm thoroughly with it. However, off the top of my, here are some potential interventions that have benefits across multiple cause areas: (a) general vaccine immunization reminders, of course, since they increase uptake of multiple vaccines and help combat multiple diseases; (b) front-of-pack labelling, which tends to have positive impact on consumption of salt (and hence the hypertension burden), sugar (and hence the diabetes burden) and general calories (and hence the obesity burden); and (c) resilient food systems (which potentially helps both in normal famines, plus more extreme nuclear winter/abrupt sunlight reduction scenarios).
Hi Nick,
I did see your forum post previously, and I'm hopeful that my team has the chance to look into that in greater depth in the future - the idea looks promising!
(Also, you should have gotten an official email about your win and about the logistics of sending you your prize money - do let me know if it hasn't arrived!)
Strongly agree. Having been on both sides of the policy advocacy fence (i.e. in government and as a consultant/advocate working from the ouside), policy ideas have to be concrete. Asking the government to improve disease surveillance (as opposed to something specific like e.g. implementing threatnet) is about as useful as asking a government to improve education outcomes by improving pedagogy, or to boost the economy by raising productivity.
Of course, you don't have to be an expert yourself per se, but you have to talk to those who are, and get their inputs - and beyond a certain point, if your knowledge of that specific space becomes great enough after working in it for a long time, you're practically an expert yourself.
While EA is great, a lot of us have naive views of how governance works, and for that matter have overly optimistic theories of change of how abstract ideas and research affect actual policies and resource allocation, let alone welfare.
Really useful, Rosie! Could only skim (as I'm about to board a flight) but looking forward to digging deeper into this.
Hi Jason,
I agree with the broad thrust of your comment that there's a tradeoff between guaranteed performance vs potentially higher impact stuff.
That said, I would push back on two points:
(1) With respect to our work being "seriously overoptimistic, especially when it comes to predicting the success and ease of lobbying efforts against considerable opposition." I think some of our earlier/shallower CEAs definitely do suffer from that, but our deep CEAs are (a) highly comprehensive, factoring in a multiple of relevant temporal/epistemic discounts; and (b) are far more sceptical of advocacy efforts (e.g. we think there is a 6% chance of success for sodium reduction advocacy in a single country over 3 years. i.e. if you did 48 country-years of lobbying you'll get one win). Amongst the various considerations informing this estimate is, of course, the reality of industry pushback.
(b) I disagree to a limited but fairly significant extent, on the notion that such work has limited room for more funding. Scaling works differently in advocacy than in direct delivery. You pay more to buy increased chances of success (e.g. the difference between funding a small NGO vs hiring a professional lobbying outfit vs hiring ex-government officials to lobby for you). Of course, diminishing marginal returns apply (as opposed to economies of scale in direct delivery - though in the long run, there's always DMR as we work our way down the list of priority countries).
CEARCH did a shallow dive into this (https://docs.google.com/spreadsheets/d/116DqgnzADo8zAmJ_QAp9AKcjKPMlgBs2Hc9E7SSAASM/edit#gid=0) and our preliminary conclusion is that the marginal expected value of funding life extension research doesn't meet our threshold of 10x GiveWell. A lot of uncertainty, obviously, but generally things look good upfront and worse later, so this wasn't a promising sign, and we decided not to spend more time on this.
Constituent pressure (via emails/calls) work, but the issue is that its the hard right within the GOP blocking PEPFAR renewal over imaginary abortion fears. If you live in a city (and probably SF/NY at that), your representative/senator is a Democrat who already agrees with you that letting poor Africans die of AIDS is morally atrocious and that PEPFAR should be renewed.
It's probably worth writing in anyway, but note that if you were originally from a red state/district before moving to where you are now, write in to your home state/district's GOP congressman for maximum effectiveness.