In response to Elie’s recent series of posts on malnutrition, John J. comments:

“What specific nutrients are they missing…etc etc etc?”

Here’s a question for you: What possible use is this question to Givewell? Do you really need to get into such miniscule depth with regard to poor people who can’t afford enough food and who are malnourished as a result?

One might accuse you of wasting the time of non profit workers with such picky detail. Serously, I’m not just being cranky here–what was the point of these questions? It seems to me that common sense is enough here: people don’t get enough of the rights kinds of foods to eat, and helping them get enough is…helpful. Really, what was your point? And, additionally, what was the point of this post at all?

First of all, we don’t believe that food aid is necessarily helpful: we’ve seen plausible arguments that it can do more damage (by undermining local farmers’ business) than good. (See this critique from Philanthropy Action, co-maintained by Board member Tim Ogden, as well as this story on CARE’s decision to withdraw from the US government’s food aid program.) Broad enough outcomes data could mitigate this concern, as could clear information on the local food market in the region in question; without it, we’d still bet that food aid is a good thing on average, but could easily be wrong.

But the reason we ask such specific questions isn’t primarily to determine whether aid helps; it’s to find the aid that will help as much as possible (in ways that fit our philosophical goals). Like any donor, we choose between literally thousands of charities; a core idea of GiveWell is that under these circumstances, it doesn’t make sense to settle for “some” good accomplished.

Given the variety of different approaches to malnutrition, we expect that different charities vary wildly in both:

• What kind of life change they’re bringing about. For example, Vitamin A deficiency may significantly increase the likelihood of death before age 5, while deficiencies in Iron and Iodine may lead to Anemia and reduced I.Q. These are fundamentally different benefits that can’t be reduced to the same terms – and that different donors will value differently. In order to understand our options, we need the details of what sorts of malnutrition are being addressed, and where.
• How many lives they’re changing (i.e., cost-effectiveness). We find it possible that some charities are simply carrying better-conceived and -executed programs than others – that means more people helped, for the same funds. And even if different malnutrition programs turned out to be roughly comparable to each other, we’d still want to know how they compare to all the other health interventions out there, from hospitals and health centers to condoms and bednets.

These issues don’t matter very much if the only line you draw is between “donation was squandered” and “donation helped people.” But if you want to help people as much as you can, the lack of public answers to our questions is a real problem.