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NickLaing

CEO and Co-Founder @ OneDay Health
10416 karmaJoined Working (6-15 years)Gulu, Ugandaonedayhealth.org

Bio

Participation
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I'm a doctor working towards the dream that every human will have access to high quality healthcare.  I'm a medic and director of OneDay Health, which has launched 53 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community  in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.

How I can help others

Understanding the NGO industrial complex, and how aid really works (or doesn't) in Northern Uganda 
Global health knowledge
 

Comments
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NickLaing
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70% agree

We all have a moral framework, built largely on our cultural background as well as intuition and experience even if we haven't thought through it deeply. Many of us don't even know where it comes from or what it is exactly.

And yeah we can rationally prioritise based on that. Thinking deeply can help us prioritise better but I don't think its necessary.

Thanks @Vasco Grilo🔸 Yes I agree that if you are using RP's mainline welfare ranges, if you choose to ignore small creatures or even adjust downwards you need a reason to do so . Even one line "we think its a low probability and a mugging" would satisfy me (if that was the reason). But using RP's ranges for other animals while ignoring smaller creatures with zero explanation doesn't fly.

I think there are good reasons though as I outlined for not expressing their reasons publicly. I would suspect that those organisations you listed might have discussed this in-house, and have decent reasons why they aren't considering small creatures but just don't want to make it public because of potential bad optics

 Maybe if you reached out to them they would share some of their reasons?

Also I think the statement "I guess effects on microorganisms, and soil nematodes, mites, and springtails are still the driver of the overall effect of the vast majority of the interventions" is not technically correct. I think what you mean is that based on RP's moral weights effects on those animals might carry the highest expected value. Even if their methods are reasonable, there's still a 93% chance that effects on those animals have no effect on any intervention right?

Thanks so much for the reply! Yep 6.3 million kids rather than 1.5 million would fix the issue that makes sense ;).

In my defence, a straightforward reading of the back-check article does seem to me to be cite 1.5 million as the number "For New Incentives, our best guess is that our $120 million in grants averted 27,000 deaths from vaccine-preventable diseases—about 60% higher than our initial estimate of 17,000 deaths. Our estimate of cost-effectiveness increased because costs per child dropped significantly as New Incentives expanded from serving 70,000 children to serving 1.5 million children." I don't think the 6.3 million number is on the review?

I should have picked up though that 120 million dollars would incentivize more than 1.5 million kids.... 

I had a good time learning more about the ins and outs of vaccinatable diseases so far from time wasted on my part ;).

As a smaller point I'm interested in the 0.75 extra lives saved you add for every 1 vaccinatable lives saved that you add as well. I know the vaccine effect seems to save lives from other causes as well (although most research on that  is pretty old), but I'm not sure where those extra lives saved would come from within the GBD bucket - its an interesting one!

 

I'm right on the side of ignoring the effects on tiny creatures.

1. I don't think Rethink's calculation techniques work as well for smaller animals as for larger ones. As I've discussed before, BOTH their sentience ranges and their behavior scores rely heavily on the presence of pain response behavior. This means if a creature have any pain averse behavior (like just withdrawing from anything), it is guaranteed a highish welfare range. If it has a few of these behaviors the numbers get high fast. Their methodology doesn't really have scope for tiny welfare ranges.

2. By my lights I consider this a mugging: I don't consider probabilities this small (for me probability of sentience is <0.0001) worth considering in calculations. Everyone has a different "mugging threshold" as it were, and for me this falls below that. If I bought RP's sentience probability of 0.07, I wouldn't consider this a mugging.

3. Net Positive lives: On the off chance these creatures are sentient, I think they most likely have net positive lives for a few reasons. 

First I buy many of the arguments in this article that both wild animal deaths and lives aren't as bad as are often claimed. 

Second if we're going to index welfare ranges on human behavior, why don't we index animal wellbeing on human wellbeing? I feel like its a bit "choke on your cake an vomit it too" to suggest that animals are much like humans in their sentience and ability to experience pain, yet don't have similar positive and negative ranges of experience that usually end up net-positive for humans, even those who live in pretty tough situations? I get this is a bit basic...

Third soil nematodes mostly just go about their business, and aren't necessarily under the continuous stress that wild prey are like deer or mice are, where I think there are better arguments for wild animal net-negativity. Yes they have plenty of predators, but I don't think they don't spend a huge proportion of their efforts avoiding them.

4. I'm not just a consequentialist utilitarian. Enough said and on this note I appreciate the recent article by @Rethink Priorities and @Marcus_A_Davis which claims we should be more uncertain about our philosophical judgements.

I buy most of @Michael St Jules 🔸 top 3 arguments as well, which are mostly practical considerations downstream of mine. I suspect he would disagree with my 3 considerations above (but could be wrong).

I think its reasonable to talk about why they are excluded, but in many cases it might be better EV not to communicate it, even when the org has considered these creatures in its calculation. The general public might well distrust orgs that consider these creatures' welfare. Like @Henry Howard🔸 said it can look crazy, but not only that, for most people it can rightly seem offensive or cruel to consider microscopic creature's welfare taking precedent over the welfare of humans or even larger animals. I have graet sympathy for people who criticize our community for indulging in discussions like this.

I could be convinced in the other direction through more compelling research that disagrees with my consideratoins above, but I think its unlikely to be forthcoming in the near future.

100% agree, this is the case for most (if not all) of my forum posts! Even if I do have some idea which even borders on original, its only a very small percent of the write up. If we look at popular non-fiction books, most present old ideas in an original way. Classic examples of people who do this well...

Noah Yuvral Harari - I excitedly recommended "Sapiens" to my wife. She stopped reading halfway through.... "This is just Anthropology 101 hyped up" :D :D :D 

Malcolm Gladwell also does a great job of this.

Its an important datapoint, but I'm skeptical that the gap is actually this much. Conformation bias might well play into this?

Thanks Lorenzo - yes looking at that now I think that 3% is the estimate for the highest under 5 mortality Nigerian state as well, others are far less. They do assign 40% of the value of the program to preventing death in other ages + increased income effects as well + 0.75 lives saved for every vaccinated kid's life saved, based on other life saving effects from vaccines (which I'm pretty dubious about) - but that doesn't change the situation enough.

Also not sure if you have seen it, but near the top of this page is a great overall summary of their calculation, which makes a lot of sense to me and I struggle to see how it gets to that apparent 9.5% of lives saved that it seemed to me they were claiming..

https://www.givewell.org/international/technical/programs/new-incentives

I'm afraid I haven't looked through the CEA in detail to figure that out so no I don't have a sense!

Hey Rowan thanks for asking! 

I would rather you didn't share the post more widely if that's ok, this is a sanity check and not a cost effectiveness analysis - and a loose check which might be plain wrong. I would want this to carry approximately zero weight about whether people would be keen to donate to New incentives or not. 

For the record this hasn't changed my opinion of New Incentives at all, I think they're a great charity! Its just a sanity check of what might be an overestimate of lives saved by GiveWell

Yep I agree!

I've done a quicky sanity check on the New Incentives numbers and it doesn't seem quite plausible, but my it was fast and I could be plain wrong.

https://forum.effectivealtruism.org/posts/FxAtFMRnJZ2dbLBhA/sanity-check-givewell-s-new-incentives-estimate-seems

I would also like to see OpenPhil look back at a bunch of their "hits based" grants. They've done a decent amount of them and I think we should be able to get some idea about whether the approach is working as planned. It wouldn't have to be too detailed. They could even do something a bit loose, like categorising them into maybe 4 buckets like .....

1. Miss          2. Probable miss         3. Some benefit       4. Home Run hit successful!

Or similar

Best video I've seen yet on the story of AI yet, amazing job! I hope this gets the reach it deserves and needs. 

The presenter Aric is extremely talented and compelling, hope to see him again in more material.

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