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	<title>Comments for The GiveWell Blog</title>
	<link>http://blog.givewell.org</link>
	<description>Exploring how to get real change for your dollar.</description>
	<pubDate>Mon,  6 Sep 2010 21:25:30 +0000</pubDate>
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		<title>Comment on New research and recommendations for microfinance by Samson Songore</title>
		<link>http://blog.givewell.org/2010/09/03/new-research-and-recommendations-for-microfinance/#comment-157266</link>
		<pubDate>Fri, 03 Sep 2010 08:49:05 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/09/03/new-research-and-recommendations-for-microfinance/#comment-157266</guid>
					<description>Congrats SEF for achieving best rating results.Keep up the good work and standards.</description>
		<content:encoded><![CDATA[<p>Congrats SEF for achieving best rating results.Keep up the good work and standards.
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		<title>Comment on New research and recommendations for microfinance by Adam J. Sorensen</title>
		<link>http://blog.givewell.org/2010/09/03/new-research-and-recommendations-for-microfinance/#comment-157263</link>
		<pubDate>Fri, 03 Sep 2010 07:42:42 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/09/03/new-research-and-recommendations-for-microfinance/#comment-157263</guid>
					<description>Congrats to SEF!  

It's great to see SEF's lasting focus on dropouts and the causes of social impact recognized with a rigourous comparison. 

Cheers,
Adam</description>
		<content:encoded><![CDATA[<p>Congrats to SEF!  </p>
<p>It&#8217;s great to see SEF&#8217;s lasting focus on dropouts and the causes of social impact recognized with a rigourous comparison. </p>
<p>Cheers,<br />
Adam
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		<title>Comment on Singularity Summit by Holden</title>
		<link>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156859</link>
		<pubDate>Wed, 01 Sep 2010 06:51:45 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156859</guid>
					<description>Nick, what I mean by 'Pascal's mugging' is still narrower than what you're saying. It isn't just a reference to low and fuzzy probabilities.

What I'm saying is that in this case, I find the arguments for the existential risk reduction charities I've seen to be very uncompelling and that I can't comfortably place something like P(SIAI will be successful) above any particular threshold.  (Not even 10^-(3^^^^3).)  The only reason I would place it above that threshold is out of a feeling that my brain pretty much isn't capable of assigning that low a probability to &lt;em&gt;any&lt;/em&gt; vaguely defined hypothesis.

Given this state of mind, it seems that it would be a mistake for me to invest, for the same reason that it's a mistake to give in to a Pascal's Mugging.  If you have a different state of mind and feel confident that, say, P(SIAI will be successful)&gt;0.01%, different conclusions follow.</description>
		<content:encoded><![CDATA[<p>Nick, what I mean by &#8216;Pascal&#8217;s mugging&#8217; is still narrower than what you&#8217;re saying. It isn&#8217;t just a reference to low and fuzzy probabilities.</p>
<p>What I&#8217;m saying is that in this case, I find the arguments for the existential risk reduction charities I&#8217;ve seen to be very uncompelling and that I can&#8217;t comfortably place something like P(SIAI will be successful) above any particular threshold.  (Not even 10^-(3^^^^3).)  The only reason I would place it above that threshold is out of a feeling that my brain pretty much isn&#8217;t capable of assigning that low a probability to <em>any</em> vaguely defined hypothesis.</p>
<p>Given this state of mind, it seems that it would be a mistake for me to invest, for the same reason that it&#8217;s a mistake to give in to a Pascal&#8217;s Mugging.  If you have a different state of mind and feel confident that, say, P(SIAI will be successful)>0.01%, different conclusions follow.
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		<title>Comment on Singularity Summit by Nick Beckstead</title>
		<link>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156711</link>
		<pubDate>Tue, 31 Aug 2010 12:37:28 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156711</guid>
					<description>I guess I misunderstood what you said here: "By “non-negligible” I mean “both above the positive expected impact of everyday good works, which improve the total resources and human capital at our disposal, and above the threshold where taking action would not constitute falling prey to Pascal’s Mugging.”

At any rate, the concern about murky probabilities might be misplaced.  Sometimes, I won't stand behind a point-valued probability estimate, but I'll be confident that the probability is at least a certain amount.  Example: I don't know how likely it is that the copper market will do really well in 30 years, but I'd say the odds are at least 1 in a thousand.  If this is what I think, if I'm willing to bet at 1:1000 odds about some event of "known" probability, I should also be willing to bet at 1:1000 odds about the claim that the copper market will be doing really well in 30 years.  Similarly, even if you can't tell what the odds are for various existential risks, I think you can say that many of them have odds above certain low thresholds (1 in a million, 1 in a thousand, etc.).  And if, given that those are the odds, we can reduce the probabilities, even by a small amount, I don't think the mugging analogy will work out.  [Brian Weatherson, a Rutgers philosopher, defends a view of this kind about probability.  You can see some details of it on the first few pages of the paper "Keynes, Uncertainty, and Interest Rates", available here: http://brian.weatherson.org/papers.shtml, under "Major Published Works".]

I think it is important to remember here that ignoring the existential risks under discussion is also a choice; if the probabilities are higher than you think, it could be a big mistake.</description>
		<content:encoded><![CDATA[<p>I guess I misunderstood what you said here: &#8220;By “non-negligible” I mean “both above the positive expected impact of everyday good works, which improve the total resources and human capital at our disposal, and above the threshold where taking action would not constitute falling prey to Pascal’s Mugging.”</p>
<p>At any rate, the concern about murky probabilities might be misplaced.  Sometimes, I won&#8217;t stand behind a point-valued probability estimate, but I&#8217;ll be confident that the probability is at least a certain amount.  Example: I don&#8217;t know how likely it is that the copper market will do really well in 30 years, but I&#8217;d say the odds are at least 1 in a thousand.  If this is what I think, if I&#8217;m willing to bet at 1:1000 odds about some event of &#8220;known&#8221; probability, I should also be willing to bet at 1:1000 odds about the claim that the copper market will be doing really well in 30 years.  Similarly, even if you can&#8217;t tell what the odds are for various existential risks, I think you can say that many of them have odds above certain low thresholds (1 in a million, 1 in a thousand, etc.).  And if, given that those are the odds, we can reduce the probabilities, even by a small amount, I don&#8217;t think the mugging analogy will work out.  [Brian Weatherson, a Rutgers philosopher, defends a view of this kind about probability.  You can see some details of it on the first few pages of the paper &#8220;Keynes, Uncertainty, and Interest Rates&#8221;, available here: <a href="http://brian.weatherson.org/papers.shtml," rel="nofollow">http://brian.weatherson.org/papers.shtml,</a> under &#8220;Major Published Works&#8221;.]</p>
<p>I think it is important to remember here that ignoring the existential risks under discussion is also a choice; if the probabilities are higher than you think, it could be a big mistake.
</p>
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		<title>Comment on Singularity Summit by Holden</title>
		<link>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156676</link>
		<pubDate>Tue, 31 Aug 2010 08:20:11 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156676</guid>
					<description>Nick, I don't automatically associate low probabilities with Pascal's Mugging.  For example, I would pay to avert a one-in-a-billion chance of a billion untimely deaths, if I had high confidence in the quantification.  What I am inclined to call a "Pascal's Mugging" is a situation in which I have no sense of an event's probability, other than that it seems very unlikely (it fits in the category of "story someone told me with no serious empirical grounding"), yet the event would hypothetically involve a huge cost/benefit, leading to the implication that I should invest significantly.  In this case it feels like I simply don't have the mental precision required to assign a probability low enough to recommend against investment, yet investment would be foolish.  That is how I feel at this point about investing in the various anti-existential-risk projects I have discussed.</description>
		<content:encoded><![CDATA[<p>Nick, I don&#8217;t automatically associate low probabilities with Pascal&#8217;s Mugging.  For example, I would pay to avert a one-in-a-billion chance of a billion untimely deaths, if I had high confidence in the quantification.  What I am inclined to call a &#8220;Pascal&#8217;s Mugging&#8221; is a situation in which I have no sense of an event&#8217;s probability, other than that it seems very unlikely (it fits in the category of &#8220;story someone told me with no serious empirical grounding&#8221;), yet the event would hypothetically involve a huge cost/benefit, leading to the implication that I should invest significantly.  In this case it feels like I simply don&#8217;t have the mental precision required to assign a probability low enough to recommend against investment, yet investment would be foolish.  That is how I feel at this point about investing in the various anti-existential-risk projects I have discussed.
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		<title>Comment on Philanthropy vouchers by Holden</title>
		<link>http://blog.givewell.org/2010/08/05/philanthropy-vouchers/#comment-156675</link>
		<pubDate>Tue, 31 Aug 2010 08:19:43 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/08/05/philanthropy-vouchers/#comment-156675</guid>
					<description>The analogy with food stamps is relevant, but not exact.  The biggest difference is that our proposal calls for a single funder, without the practical and political restrictions of government, to set the ground rules.  A smaller number of "vendors" with a higher level of accountability would be possible than with food stamps.</description>
		<content:encoded><![CDATA[<p>The analogy with food stamps is relevant, but not exact.  The biggest difference is that our proposal calls for a single funder, without the practical and political restrictions of government, to set the ground rules.  A smaller number of &#8220;vendors&#8221; with a higher level of accountability would be possible than with food stamps.
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		<title>Comment on Singularity Summit by Nick Beckstead</title>
		<link>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156491</link>
		<pubDate>Mon, 30 Aug 2010 12:58:56 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/06/29/singularity-summit/#comment-156491</guid>
					<description>I share some of your worries about non-contingency and Pascal's Mugging.

On the Pascal's Mugging point, I think it is important to remember that much of the low chances of making a difference associated with existential risk turn on the fact that we're dealing with a collective action problem.  Like voting, fighting in a just and important war, or not producing a lot of C02, the odds are that your personal action will not be decisive.  However, when your action is part of a large collective and the action of the collective does well on average, it is often reasonable to cooperate.  (Parfit makes related points in the section called “Five Mistakes in Moral Mathematics” in Reasons and Persons).

As an example, take voting.  In some swing states, the odds that your vote is decisive in a presidential election is in the ballpark of 1 in 10 million (http://onlinelibrary.wiley.com/doi/10.1111/j.1465-7295.2010.00272.x/abstract).  If there were an important election going on, it would be unreasonable to argue that voting was irrational on the grounds that it is like a case of Pascal's Mugging.  Perhaps you have better things to do with your time, but it wouldn't be a mugging.  (Perhaps you wouldn't have better things to do: if the decision would significantly affect the lives of 10 million people (which it easily could in an important election), a few minutes to vote might not be a bad idea.)

In my view, decreasing the chance of existential risk by 1% would be more important than having a presidential election turn out well (provided the election itself didn't also significantly reduce existential risk; counting only people who already exist, this would save 70 million expected lives).  By parallel reasoning, if some effort we could make would have a 1 in 10 million chance of decreasing existential risk by 1%, paying for the opportunity wouldn't count as getting mugged.  Here, though, one would only be decreasing the chance of existential risk by 1 in a billion.  This suggests, but does not show, that the probabilities can be quite small before a low probability high stakes bet becomes a mugging.

The argument does not show that folks who worry about existential risk are not being mugged because  the analogy is not perfect; in the case of voting, many other people are likely to cooperate (though your personal decision may have little to do with that).  In the case of existential risk, few people are likely to cooperate (though here there seems to be more potential for influence).  If this difference is deemed to be relevant, than existential risks folks are possibly being mugged.  If it is not, then they are not being mugged (though other things may have higher expected return).

Let's say the number of potential cooperators is not relevant in this way (provided the chance of success remains constant).  If we could show that it were possible to decrease the probability of existential risk by more than 1 in a billion, that would show that we aren't really dealing with a mugging.  I can't show this, but I do find it plausible.  A lifetime of effective donations really could, I believe, decrease the odds of existential risk by 1 in a billion.  If you buy all of that, we aren't dealing with a mugging.</description>
		<content:encoded><![CDATA[<p>I share some of your worries about non-contingency and Pascal&#8217;s Mugging.</p>
<p>On the Pascal&#8217;s Mugging point, I think it is important to remember that much of the low chances of making a difference associated with existential risk turn on the fact that we&#8217;re dealing with a collective action problem.  Like voting, fighting in a just and important war, or not producing a lot of C02, the odds are that your personal action will not be decisive.  However, when your action is part of a large collective and the action of the collective does well on average, it is often reasonable to cooperate.  (Parfit makes related points in the section called “Five Mistakes in Moral Mathematics” in Reasons and Persons).</p>
<p>As an example, take voting.  In some swing states, the odds that your vote is decisive in a presidential election is in the ballpark of 1 in 10 million (http://onlinelibrary.wiley.com/doi/10.1111/j.1465-7295.2010.00272.x/abstract).  If there were an important election going on, it would be unreasonable to argue that voting was irrational on the grounds that it is like a case of Pascal&#8217;s Mugging.  Perhaps you have better things to do with your time, but it wouldn&#8217;t be a mugging.  (Perhaps you wouldn&#8217;t have better things to do: if the decision would significantly affect the lives of 10 million people (which it easily could in an important election), a few minutes to vote might not be a bad idea.)</p>
<p>In my view, decreasing the chance of existential risk by 1% would be more important than having a presidential election turn out well (provided the election itself didn&#8217;t also significantly reduce existential risk; counting only people who already exist, this would save 70 million expected lives).  By parallel reasoning, if some effort we could make would have a 1 in 10 million chance of decreasing existential risk by 1%, paying for the opportunity wouldn&#8217;t count as getting mugged.  Here, though, one would only be decreasing the chance of existential risk by 1 in a billion.  This suggests, but does not show, that the probabilities can be quite small before a low probability high stakes bet becomes a mugging.</p>
<p>The argument does not show that folks who worry about existential risk are not being mugged because  the analogy is not perfect; in the case of voting, many other people are likely to cooperate (though your personal decision may have little to do with that).  In the case of existential risk, few people are likely to cooperate (though here there seems to be more potential for influence).  If this difference is deemed to be relevant, than existential risks folks are possibly being mugged.  If it is not, then they are not being mugged (though other things may have higher expected return).</p>
<p>Let&#8217;s say the number of potential cooperators is not relevant in this way (provided the chance of success remains constant).  If we could show that it were possible to decrease the probability of existential risk by more than 1 in a billion, that would show that we aren&#8217;t really dealing with a mugging.  I can&#8217;t show this, but I do find it plausible.  A lifetime of effective donations really could, I believe, decrease the odds of existential risk by 1 in a billion.  If you buy all of that, we aren&#8217;t dealing with a mugging.
</p>
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		<title>Comment on Needed from major funders: more great organizations by Beth Steinberg</title>
		<link>http://blog.givewell.org/2010/08/13/needed-from-major-funders-more-great-organizations/#comment-156230</link>
		<pubDate>Sun, 29 Aug 2010 08:07:17 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/08/13/needed-from-major-funders-more-great-organizations/#comment-156230</guid>
					<description>Hear, hear for expressing this sentiment. I would add that what also bothers me is this focus on 'contests' for dollars. I co-founded and run a small program in Jerusalem, Israel. Inclusion programs - informal education - for kids and teens with special needs. I think what we're doing could be ground breaking in the long run but running the program takes up marketing energy and as for contests? I just think that dilutes the message of Shutaf - creating social change through quality programs in an atmosphere of acceptance of inclusion. 

We work hard for our fundraising dollars and are proud that we continue to be supported by mostly smaller donors, who like what we're doing and believe that it's special. Yes, we need capacity building funds and more but I just feel that it will come when we're ready and when we've done the groundwork we needed to do.</description>
		<content:encoded><![CDATA[<p>Hear, hear for expressing this sentiment. I would add that what also bothers me is this focus on &#8216;contests&#8217; for dollars. I co-founded and run a small program in Jerusalem, Israel. Inclusion programs - informal education - for kids and teens with special needs. I think what we&#8217;re doing could be ground breaking in the long run but running the program takes up marketing energy and as for contests? I just think that dilutes the message of Shutaf - creating social change through quality programs in an atmosphere of acceptance of inclusion. </p>
<p>We work hard for our fundraising dollars and are proud that we continue to be supported by mostly smaller donors, who like what we&#8217;re doing and believe that it&#8217;s special. Yes, we need capacity building funds and more but I just feel that it will come when we&#8217;re ready and when we&#8217;ve done the groundwork we needed to do.
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		<title>Comment on Philanthropy vouchers by J. S. Greenfield</title>
		<link>http://blog.givewell.org/2010/08/05/philanthropy-vouchers/#comment-156056</link>
		<pubDate>Sat, 28 Aug 2010 16:13:26 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/08/05/philanthropy-vouchers/#comment-156056</guid>
					<description>Holden, I wouldn't call what you're describing "philanthropy vouchers."  To my view, the term "philanthropy voucher" implies giving somebody a voucher to engage in philanthropic activities: delegation of philanthropic power.  When Warren Buffet gives each of his kids a billion dollars to give away, that's a (really big) philanthropy voucher.

Because of the name, and because a few comments within your post, I thought your idea was that local individuals (many, most or all needy, themselves) would effectively prioritize where philanthropic dollars were directed, by choosing the non-profits to receive their dollars.

That, I think, is an interesting idea.  Not sure that it would actually improve outcomes, but it's at least an interesting idea to think about.

However, I expect any such benefit is undermined if the vouchers are effectively used as coupons to purchase goods or service for personal benefit.  Then I think it is similar to cash (and we can argue over the pros and cons in terms of efficiency at achieving intended purposes).

What you are describing sounds to me like a broader version of food stamps.  In practice, I don't think food stamps have proven terribly effective at preventing people from using welfare grants for unintended/prohibited goods, like tobacco and alcohol.  So I'm a bit skeptical that they would prove more successful in this context.  Perhaps they can be marginally more successful than food stamps, if the volume of vouchers is large relative to the local economy, but I wouldn't be incredibly optimistic that they wouldn't become tradable for any purpose, at some discount that people are willing to give up, to get what they desire.</description>
		<content:encoded><![CDATA[<p>Holden, I wouldn&#8217;t call what you&#8217;re describing &#8220;philanthropy vouchers.&#8221;  To my view, the term &#8220;philanthropy voucher&#8221; implies giving somebody a voucher to engage in philanthropic activities: delegation of philanthropic power.  When Warren Buffet gives each of his kids a billion dollars to give away, that&#8217;s a (really big) philanthropy voucher.</p>
<p>Because of the name, and because a few comments within your post, I thought your idea was that local individuals (many, most or all needy, themselves) would effectively prioritize where philanthropic dollars were directed, by choosing the non-profits to receive their dollars.</p>
<p>That, I think, is an interesting idea.  Not sure that it would actually improve outcomes, but it&#8217;s at least an interesting idea to think about.</p>
<p>However, I expect any such benefit is undermined if the vouchers are effectively used as coupons to purchase goods or service for personal benefit.  Then I think it is similar to cash (and we can argue over the pros and cons in terms of efficiency at achieving intended purposes).</p>
<p>What you are describing sounds to me like a broader version of food stamps.  In practice, I don&#8217;t think food stamps have proven terribly effective at preventing people from using welfare grants for unintended/prohibited goods, like tobacco and alcohol.  So I&#8217;m a bit skeptical that they would prove more successful in this context.  Perhaps they can be marginally more successful than food stamps, if the volume of vouchers is large relative to the local economy, but I wouldn&#8217;t be incredibly optimistic that they wouldn&#8217;t become tradable for any purpose, at some discount that people are willing to give up, to get what they desire.
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		<title>Comment on Neglected Tropical Disease charities: Schistosomiasis Control Initiative, Deworm The World by Holden</title>
		<link>http://blog.givewell.org/2010/06/09/neglected-tropical-disease-charities-schistosomiasis-control-initiative-deworm-the-world/#comment-155809</link>
		<pubDate>Fri, 27 Aug 2010 12:25:23 +0000</pubDate>
		<guid>http://blog.givewell.org/2010/06/09/neglected-tropical-disease-charities-schistosomiasis-control-initiative-deworm-the-world/#comment-155809</guid>
					<description>Will, I disagree that you assume that charities are "average at implementing their intervention."  As noted &lt;a href="http://blog.givewell.org/2010/03/19/cost-effectiveness-estimates-inside-the-sausage-factory/" rel="nofollow"&gt;elsewhere&lt;/a&gt;, cost-effectiveness estimates are generally based on studies of particularly carefully observed programs that are known to have been carried out in a sustained, competent, successful way.  Cost-effectiveness can drop to zero or negative if these conditions are no longer met.  So by using cost-effectiveness estimates the way you do, you seem to be implicitly assuming that charities are "as effective as the studied projects," not that they are "average."  We have too little information to know the relationship between these two things, but they are conceptually extremely different.

I have two issues with your statement about Deworm the World (DtW).  The first is that I don't think it's valid to multiply 74% by the "estimated midpoint competent-case expected cost-effectiveness of the program" to get overall midpoint expected impact, and that in fact 74%*A can be a worse bet than 100%*B even when A is estimated to be 2*B by best available estimates.  I elaborated on this view &lt;a href="http://blog.givewell.org/2010/03/19/cost-effectiveness-estimates-inside-the-sausage-factory/" rel="nofollow"&gt;in our other discussion&lt;/a&gt;.  

The second issue is that you seem to assume that "technical assistance and scaling up deworming programs" can be considered equivalent in cost-effectiveness to "executing deworming programs."  In fact, we don't know what impact DtW's technical assistance has on the scale and effectiveness of government deworming programs.  Note that if we analyzed VillageReach similarly to the way you analyze DtW, we would have a very different and more favorable cost-effectiveness estimate for them: in digging into what they do and what it costs, we have found it possible that they are spending several times more per unit (life saved / DALY) than the outright DCP estimate of pure vaccination programs.  (&lt;a href="http://www.givewell.org/international/top-charities/villagereach#Whatdoyougetforyourdollar" rel="nofollow"&gt;Details.&lt;/a&gt;)  I would guess this is the case for many charities focusing on assistance/modification rather than direct delivery, and few provide direct delivery as this is often considered to be the government's proper role.

I disagree with your point about educational benefits as well.  The fact that educational benefits have been observed for deworming and not DOTS seems to me to be more an artifact of what has been measured that a fundamental fact about the two different programs.  For example, if DOTS saves the lives of parents, I would guess this has a positive impact on children's educational experiences; it just hasn't been examined.  Also note that deworming has not been observed to have any effect on &lt;em&gt;performance&lt;/em&gt; in school, only &lt;em&gt;attendance&lt;/em&gt;; while I think it is a defensible view that deworming is a better bet to improve educational outcomes than education-focused interventions, I don't think the evidence is any stronger than for DOTS that its benefits truly extend beyond health.</description>
		<content:encoded><![CDATA[<p>Will, I disagree that you assume that charities are &#8220;average at implementing their intervention.&#8221;  As noted <a href="http://blog.givewell.org/2010/03/19/cost-effectiveness-estimates-inside-the-sausage-factory/" rel="nofollow">elsewhere</a>, cost-effectiveness estimates are generally based on studies of particularly carefully observed programs that are known to have been carried out in a sustained, competent, successful way.  Cost-effectiveness can drop to zero or negative if these conditions are no longer met.  So by using cost-effectiveness estimates the way you do, you seem to be implicitly assuming that charities are &#8220;as effective as the studied projects,&#8221; not that they are &#8220;average.&#8221;  We have too little information to know the relationship between these two things, but they are conceptually extremely different.</p>
<p>I have two issues with your statement about Deworm the World (DtW).  The first is that I don&#8217;t think it&#8217;s valid to multiply 74% by the &#8220;estimated midpoint competent-case expected cost-effectiveness of the program&#8221; to get overall midpoint expected impact, and that in fact 74%*A can be a worse bet than 100%*B even when A is estimated to be 2*B by best available estimates.  I elaborated on this view <a href="http://blog.givewell.org/2010/03/19/cost-effectiveness-estimates-inside-the-sausage-factory/" rel="nofollow">in our other discussion</a>.  </p>
<p>The second issue is that you seem to assume that &#8220;technical assistance and scaling up deworming programs&#8221; can be considered equivalent in cost-effectiveness to &#8220;executing deworming programs.&#8221;  In fact, we don&#8217;t know what impact DtW&#8217;s technical assistance has on the scale and effectiveness of government deworming programs.  Note that if we analyzed VillageReach similarly to the way you analyze DtW, we would have a very different and more favorable cost-effectiveness estimate for them: in digging into what they do and what it costs, we have found it possible that they are spending several times more per unit (life saved / DALY) than the outright DCP estimate of pure vaccination programs.  (<a href="http://www.givewell.org/international/top-charities/villagereach#Whatdoyougetforyourdollar" rel="nofollow">Details.</a>)  I would guess this is the case for many charities focusing on assistance/modification rather than direct delivery, and few provide direct delivery as this is often considered to be the government&#8217;s proper role.</p>
<p>I disagree with your point about educational benefits as well.  The fact that educational benefits have been observed for deworming and not DOTS seems to me to be more an artifact of what has been measured that a fundamental fact about the two different programs.  For example, if DOTS saves the lives of parents, I would guess this has a positive impact on children&#8217;s educational experiences; it just hasn&#8217;t been examined.  Also note that deworming has not been observed to have any effect on <em>performance</em> in school, only <em>attendance</em>; while I think it is a defensible view that deworming is a better bet to improve educational outcomes than education-focused interventions, I don&#8217;t think the evidence is any stronger than for DOTS that its benefits truly extend beyond health.
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