All of Marshall's Comments + Replies

It's great to see more thoughtful posts proposing new global health and development interventions. Upvoted.

Just sharing as an FYI - one of the key papers you cite for the cost-effectiveness analysis issued a correction, and the revised estimate of DALYs averted is 149 thousand rather than 14.9 million. It looks like there was an order of magnitude error somewhere along the way in their calculations.

Thanks - this is super interesting and I agree that hypertension is a promising cause area - and that taxes on unhealthy foods may be a promising intervention.

The estimate of the degree to which an average 1 mg reduction in sodium consumption reduces incidence of high systolic blood pressure in a single country and hence the global disease burden of hypertension, relies on an extremely long and complicated chain of calculations – there is hence a high degree of uncertainty here.

I agree with your assessment that this is an area of uncertainty. In particular... (read more)

Thanks for this feedback! This is exactly why I posted, so before I provide any specific responses to your points, please know that I appreciate all of the questions and suggestions and I'm already thinking of how they could be addressed in a future version of this proposal.

1. I appreciate your point that the key step in the theory of change is not clear - and I think this is not due to a gap in the data itself but instead due to a gap in my presentation of the evidence. The key supporting evidence is linked out from this statement:

My analysis of existing

Many thanks for reading and for your suggestions, which I've acted on! The title is now updated :).

Thanks! I have a few possible names but haven't picked one (and the associated website domain name) yet. The pilots described here recently wrapped up but I'd be happy to share a demo module hosted on our MVP that's focused on neonatal / child health. Please DM me if you're interested.

Thanks so much. This is a tour de force! I have one more suggestion about this model. I know that GiveWell has strong reasons to use its own metrics rather than DALYs or QALYs. The problem is that DALYs and QALYs are much more widely used in the academic literature.

My suggestion is the model should report estimated $/DALY averted in addition to  (not instead of) the preferred units of cost-effectiveness as a multiple of cash transfers. This would:

• Provide up-to-date benchmarks to catalyze shallow investigations of new cause areas.  There's no need

Thanks, your points make a lot of sense to me! The case does seem to be stronger for R&D generally and it's helpful to know that you're not arguing for investment in a specific stage of research. I also agree that targeting existing interventions for improvement could be very high yield :).

This is very neat, thanks for sharing! Some comments.

First, the term “academic research” is used a lot in the text. Does this modeling speak to a need for more academic research or more research and development more generally? 

• It’s not clear to me that academia (as opposed to say, the nonprofit sector or even for-profit business) can claim the best track record of creating effective interventions. Academia might be involved at early stages but interventions often transition out of the academy when they scale up.
• In other sectors, development (after the

Thanks for the great post! 

I completely agree and have been thinking about many of the same things. Many of the properties that make for-profit startups such a source of innovation (razor focus, fast decision-making, competition, rapid iteration) could also apply to nonprofit startups aiming to become highly effective. Here's a bit of a challenge that I see in this:

• The EA community has high standards of evidence for effective interventions. 
• Interventions that now have the highly effective label probably had high R&D costs to begin with, but n

Thanks for the post. Some quick comments!

I think that people now matter more than people in the future.

This could be interpreted as a moral claim that, on an individual basis, a current person matters more than a counterfactual future person. Based on the rest of your post, I don't think you're claiming that at all. Instead you're making arguments about the uncertainty of the future. 

I think a lot has been written about these claims around future uncertainty and those well-versed in longtermism have some compelling counterarguments. It would be nice to see a concise summary of the arguments for and  against written in a way that's really accessible to an EA newcomer.

Thanks for this great analysis. This definitely speaks to some limitations of the most widely-used global health and well-being metrics. It seems to me that sugar taxes could be particularly promising due to multiple public health benefits (not only improvements in dental health). This seems like a worthy contender for the Cause Exploration Prizes; you might consider submitting it if you haven't already!

Thanks! I agree - AI risk is at a much earlier stage of development as a field. Even as the field develops and experts can be identified, I would not expect a very high degree of consensus. Expert consensus is more achievable for existential risks such as climate science and asteroid impacts that can be mathematically modeled with high historical accuracy - there's less to dispute on empirical / logical grounds. 

A campaign to educate skeptics seems appropriate for a mature field with high consensus, whereas constructively engaging skeptics supports the advancement of a nascent field with low consensus.

Thanks! I thought this was great. I really like the goals of fostering a more in-depth discussion and understanding skeptics' viewpoints. 

I'm not sure about modeling a follow-up project on Skeptical Science, which is intended (in large part) to rebut misinformation about climate change. There's essentially consensus in the scientific community that human beings are causing climate change, so such a project seems appropriate.

•  Is there an equally high level of expert consensus on the existential risks posed by AI?
• Have all of the strongest of the AI

Thanks to the authors for an excellent post! This is clearly an important problem. I wonder if it would be possible to estimate cost-effectiveness ($ per DALY averted) of some existing programs to norm this against global health and development causes currently favored by the EA community, such as GiveWell's top charities?

Thanks for the comment! I agree with you - ensuring that the training works truly is the key. There are multiple lines of evidence showing that it's entirely possible to create  effective online training for health workers - all of the technology exists. There's more to be said on this than can be covered well in one comment, but here are some thoughts. 

• It's critical to have an understanding of why  most online learning doesn't work well and deliberately design better solutions based upon that understanding.
• There's plenty of research demonst

Thanks for the comment and for reading! I agree with your interpretation of neglectedness: even when we account for both government and philanthropic aid, neonatal health is underfunded. My main point there is that philanthropic interventions will need to complement national priorities given the huge role that governments play in this space.

You’re also correct that delivering trainings is complex, but I think it's surmountable. As far as I know, many of the cost-effectiveness studies cited were done in government-supported health facilities, so t... (read more)

Thanks, I accept the critique. I do think it's clear from the full post, however, that I'm just making the case for greater focus by the community, rather than saying this is a closed case. I also state clearly in the same paragraph that other studies had  much higher cost estimates.

Super interesting and thank you for sharing! A potential advantage of vaccination is that it does not require daily dosing (unlike hypertension medications), and of course, it has the benefit of also preventing illness. Would be interesting to see cost-effectiveness analyses for seasonal influenza campaigns.

Thanks for the link! I look forward to reading up on it.

Thanks for reading and for the support! I like suggestion of a prize, which could encourage some risk-taking but also orient investment towards an objectively defined goal. Another way to extend the model would be for more and more venture philanthropists to explicitly adopt this strategy of funding projects that push towards GiveWell listing, recognizing that this is their opportunity to "exit" (IE - move on to funding other promising projects).

Thanks for the support! Eager to learn more and will read your post on impact markets  :)