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NickLaing

CEO and Co-Founder @ OneDay Health
12089 karmaJoined Working (6-15 years)Gulu, Ugandaonedayhealth.org

Bio

Participation
1

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
1563

Thanks for the update, and the reasons for the name change make s lot of sense

Instinctively i don't love the new name. The word "coefficient" sounds mathsy/nerdy/complicated, while most people don't know what the word coefficient actually means. The reasoning behind the name does resonate through and i can understand the appeal.

But my instincts are probably wrong though if you've been working with an agency and the team likes it too.

All the best for the future Coefficient Giving!

Thanks @mal_graham🔸  this is super helpful and makes more sense now. I think it would make your argument far more complete if you put something like your third and fourth paragraphs here in your main article. 

And no I'm personally not worried about interventions being ecologically inert. 

As a side note its interesting that you aren't putting much effort into making interventions happen yet - my loose advice would be to get started trying some things. I get that you're trying to build a field, but to have real-world proof of this tractability it might be better to try something sooner rather than later? Otherwise it will remain theory. I'm not too fussed about arguing whether an intervention will be difficult or not - in general I think we are likely to underestimate how difficult an intervention might be.

Show me a couple of relatively easy wins (even small-ish ones) an I'll be right on board :).

Love this comment so so much! Only minor disagreement is that I think the forum here isn't a bad place to have a bit of a "vibes based" conversation about a campaign like this. Then we can move into great analysis like yours right here.


Thanks for this reply - I agree with most of what you have written here.

I think though you've missed some of the biggest problems with this campaign.

1. This seems to undermine vegans and vegetarians (see image above), and their efforts to help animals. It seems straightforwardly fair to interpreted this as anti-veganuary and anti-vegan, especially at a glance.

2. What matters in media is how you are portrayed, not what the truth is. Your initial campaign poster is ambiguous enough that its easy to interpret as a pro meat-eating campaign and anti-vegan campaign. I could have interpreted it as that myself, I don't think the media were grossly wrong here to report that.

The Telegraph article is pretty good actually overall and makes good points that could be good for animal welfare, although the first "clickbaity" title and paragraph is unfortunate (see above)

 Media lasts for a day, correcting it is the right thing to do but doesn't have much of an impact.

I can see what you are trying to do here, and its quite clever. I love most of your stuff, but this campaign seems like a mistake to me.

You're right that we aren't the target audience. I take this as probably evidence in the other direction. I think if EA's on the forum feel uncomfortable about this, the general public is likely to take it even worse than us.

I agree that its a light-hearted campaign, that is clever with good intentions. I just think its a mistake and might well do more harm than good. That's OK, this is just one campaign among many great ones from FarmKind

After having a quick look at this campaign, it pretty straightforwardly seems misguided and confusing. Farmkind's efforts to appeal to regular people to donate rather than go vegan seems good and makes sense. This adversarial campaign looks and feels awful. Two reasons immediately jumped out as to why it feels off.

  1. it undermines and even goads vegans and vegetarians doing their bit for animals
  2. glorifying people who eat lots of meat feels bad in a guttaral almost "Kantian" kind of way, regardless of the utilitarian calculation. 

In general i think complex utilitarian arguments struggle to be communicated well in pithy campaigns.

I'm surprised the FarmKind people have made what seems like a pretty straightforward mistake like this, I've been super impressed by all the other material they have put out.

I get the good intentions here but it looks to have backfired badly. Obviously I'm not deep in this but I hope that withdrawing the campaign and a quick apology is on the table for you guys at least. All the best figuring it out!

why does it take years to recruit as small number of patients if sufferers are so enthusiastic about this as a potential treatment?

First.."If it took an FDA approved RCT to get a family member free from torture I would not wait. And if it was illegal or broke FDA norms that would not stop me."

 I agree with this. even if it might be placebo if a family member was this convinced of something working, I would probably get it for them illegally. This isn't related by my lights to the question of following proper process.

Second.. "suffering exists on an exponential scale, and these truly represent the end of this spectrum. This is an affliction worse than torture. Survivors of both have said cluster headaches were worse."

this is a tragedy for sure but I think we have to be careful not to make arguments like this is the only situation where delay causes lots of suffering.

recently a malaria vaccine rollout sat waiting a while for FDA approval. every day delay the might have cost tens of lives (just a guess). I'm not saying waiting for FDA approval is the best situation, but this is not a special case, tragic delays happen all the time.

I do see that as a string argument, but i still think drugs should only go to market legally when both safety and efficacy has been proven in well enough powered RCTs. The risk to the medical profession and the reputation of the drug production industry is just too high to allow any less i think. There's no reason a fast tracked RCT couldn't get this sorted in a year and that seems like a reasonable way forward.

The RCT should also be vs. tryptans and not vs. placebo. I'm not sure why the previous small trials were not done vs. standard best practice, that seems odd to me?

 If I was sitting in the FDA reviewing this i would still be pretty nervous about making an exception.

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