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Larissa Hesketh-Rowe

. This is enough to protect over 1,400 children from the life-destroying effects of 4 

What does this mean for the individuals with schistosomiasis or intestinal worms? Who are the people that these donations will help?

Madagascar, an island off the coast of Southeast Africa, is one country that receives funds like those from my half marathon. Madagascar is known for its incredible wildlife, 80% of which is found nowhere else in the world, but less well known is that an estimated 

92% of Malagasy live on less than $2 per day

 (World Bank). Madagascar has only recently started to receive some international aid after a political crisis in 2009 left the country isolated.

With such a high percentage of the population living below the poverty line, it is not surprising that 

. Millions of children and adults have gone untreated for years. 

Up to 90% of school-age children were found to have at least one NTD.

The SCI is assisting the Ministry of Public Health (MoH) and the Ministry of Education (MoE) in Madagascar to develop and deliver a comprehensive and robust national treatment programme for school-age children. SCI assists in the training of teachers, community health workers and officials to provide treatment against schistosomiasis and soil-transmitted helminths (STH). Working together they develop appropriate targeted materials to promote treatment in the community (e.g. flyers, posters, story books, radio and local meetings),and try and reach as many adults and children as possible, both in and out of school.

Madagascar is a large island with poor infrastructure, which means that reaching more remote communities might only be possible by boat or ox driven cart. This makes the delivery of treatment to the more remote villages even more remarkable.

Interviews provided by the Schistosomiasis Control Initiative

Fourteen-year-old Jean-Baptiste Lala lives with his mother and five siblings in one such small village in rural Madagascar. Like so many boys his age he loves playing football, although they do not even have a ball where he lives.

Jean-Baptiste dreams of going to school to become a teacher, but sadly he missed school a lot recently because of stomach aches and tiredness. His mother said he gradually lost weight and even the usual interest he had in friends and school. “He just sleeps all day”, she says. Jean-Baptiste and his friends often play in a lake infested with schistosome larvae, and have no access to clean water. It’s not surprising that so many children like him and his friends become infected.

Thanks to support from the SCI, the MoH and MoE’s National Schistosomiasis and STH Control Programme are able to reach villages like Jean-Baptiste’s. A group of specialists and technicians assessed him and his friends along with the other children in the village. They found that his bloody urine contains hundreds of schistosome eggs, and that other children were infected with intestinal worms. This is the case for many other children in the village, and free treatment will be provided.

Elodia Razanadakoto, a teacher in Jean-Baptiste’s village said,“so many children were infected with schistosomiasis that it was simply considered normal to have blood in your urine.”

If Madagascar and the SCI receive enough financial resources, the National Schistosomiasis Control Programme will be able to continue delivering treatments to millions of children like Jean-Baptiste and his friends, so that they can stay well, go to school and achieve their childhood dreams.

At the moment, the MoH, MoE and the SCI only have enough resources to be able to roll out treatment for some children. 

With more funding they will be able to achieve national coverage, ensuring all children and adults at risk receive the life changing treatment they so desperately need.

 The physical effects of NTDs prevent children from going to school and fulfilling their potential, trapping them in poverty. Adults can lose their livelihoods and ability to provide for their families.

Maria Floricia Razafirondra is a young nurse. Her mother got schistosomiasis working in the rice fields where their irrigation systems can harbour schistosomiasis-infected snails. Madagascar consumes more rice per capita than any other nation in the world. While Maria’s mother was very lucky to receive treatment for schistosomiasis, she no longer works in the rice fields because she is likely to be infected again. If she had access to regular treatment she could regain her livelihood.

The SCI is consistently ranked one of the most cost-effective charities you can donate to. 

A donation of just £10 would facilitate a year’s worth of treatment for twenty people.

 But that’s not just a fantastic statistic, the knock-on effects are huge. 

£10 translates into twenty people like Maria’s mother, able to work and feed their families. £10 translates into twenty children like Jean-Baptiste and his friends, regaining their energy, doing well at school and getting one step closer to a bright future.

SCI in Madagascar

Sebastian Farquhar

This is the summary of an article by the Global Priorities Project. You can read the whole article 

Global public health remains a top contender for the best way to improve welfare through aid. Within health interventions, it is natural to allocate marginal spending to avert the most expected DALYs (disability adjusted life-years) per dollar.[1]

However, not all DALYs are the same and there are important differences between years of life lost (YLLs) and years lived with disability (YLDs). Not accounting for these categories separately may introduce a bias in decision-making because DALYs do not address non-health outcomes for individuals and the effects of outcomes on others. These effects are different in situations which involve primarily YLLs as opposed to YLDs. This analysis is of particular practical importance to effective altruists because two of the most promising interventions address different types of DALYS – deworming primarily averts YLDs and bed nets to prevent malaria primarily avert YLLs.[2] This make us more inclined towards deworming as a top intervention than a naive evaluation would suggest. More sophisticated analyses incorporate terms that address many of these effects, but may still undervalue deworming relative to malaria nets.

This document is primarily written for people who already place a high weight on DALYs in identifying top public health opportunities. It does not argue for the use of DALYs, or consequentialist reasoning in identifying public health opportunities.

For example, a simple reading of the work of the 

 2nd edition, suggests such an approach. Some evaluators, such as 

, place much less emphasis on averting DALYs.

Why averting a DALY through deworming may be better than through malaria nets

Caleb Ontiveros

, is now out in both the US and the UK. Visit the website for the book 

 and take part in the giving game to decide which effective charities the profits from selling the book get donated to - and encourage your friends to do the same - 

 presents the following case: suppose you can choose to visit an art museum. On one option, you will see the museum and visit an enticing new wing while on the other option you will see the museum without visiting the new wing. However, there is an evil demon that despises the new wing and so inflicts fifteen years of blindness on one random person out of every hundred people who visit the new wing. Would you visit the new wing? Definitely not!

If you wouldn’t then you are suggesting that the harm of fifteen years of blindness outweighs the benefit of one hundred people visiting the new wing. Now suppose you can make a donation to a museum that will allow one hundred people to see a new wing or donate to a charity that prevents fifteen years of blindness—which should you donate to?

These questions are of central importance to effective altruists. Effective altruism is a philosophy and social movement which applies evidence and reason to working out the most effective ways to improve the world. Singer’s book 

 serves as a fine introduction to the emerging movement. The book is divided into four sections: the first defines and offers a backdrop for effective altruism, the second considers how to do the most good, the third focuses motivation and justification, and the fourth discusses choosing causes and organizations.

Aiming to do the most good, many effective altruists live fairly modestly and give the rest of their income to effective charities. One may 

, that is, attempt to make a very high income in order to give that income away. For example, by 

 one can save hundreds of lives. Others may 

 that others give and effectively make the world a better place. Promoting or working for groups like Giving What We Can, or even making an effective altruism meet-up could be a fantastic way to spread effective altruist ideas, and so make the world a better place through advocacy. Similarly, one may 

 causes or organizations in order to assess how effective they may be. Other promising routes include working as a 

, directing funds to the most effective projects, or starting an effective organization.

One of the best aspects of the book is that Singer focuses on actual people who carry out these strategies. 

These goals are not unattainable nor do they demand burdensome sacrifices

. Nonetheless, one may worry that behaving as an effective altruist is too much of a sacrifice. Happily, however, 

effective altruists take joy in their altruistic projects

 and find doing good, as do most people, sincerely rewarding and meaningful. As Singer states, “We can regard people as altruists because of the kind of interests they have rather than because they are sacrificing their interests” (103).

Why should one be an effective altruist? Many altruists see it as a moral matter: we can give to others, without damaging our own lives in the process, in order to save lives—shouldn’t we do this? And 

shouldn’t we save as many lives and prevent as much suffering as we can

? Singer and many others have, and continue to, persuasively argue that the answer to both questions is yes. But there are other reasons to be an effective altruist: as mentioned, most people find that doing good promotes meaning and happiness in their lives and others. This is illustrated by the altruists who “walk cheerfully over the world.”

But, if we are to give, where should we give to? What causes or organizations do the most good? Can we make judgements about what charities do more good than others? The initial case involving the new wing of a museum suggests that we can. We can compare the good of donating to a museum or to a charity which prevents blindness.

There will, however, be less clear cases. Effective altruists tend to be concerned about global poverty and health, animal welfare, and existential risk. They want to decrease the suffering of human and nonhuman animals as well as prevent the extinction of sentient life. There is much debate between effective altruists about which of these causes are the most important—where can we do the most good? Singer provides an excellent introduction to the nuances of this debate, though people who are familiar with and active within the community will find little new here.

Those who are not familiar with effective altruism will benefit greatly from this book. It is exceptionally lucid, engaging, and careful. Singer helpfully addresses some of the most prevalent concerns people tend to have about effective altruism and persuasively argues why it is such an important movement. I would encourage anyone who is unfamiliar with or who would like to know more about effective altruism to read this book. Similarly, those who want to peak others interest in effective altruism would do well to recommend or give this book to others.

 largely conveys ideas that many effective altruists will be familiar with. Nonetheless, I would still suggest that people already very familiar with effective altruism read the book. It is 

brilliantly inspiring and provides an excellent model for how to present effective altruist ideas

Effective Altruism makes for an exciting movement and The Most Good You Can Do should propel this excitement as the movement grows.

Peter Singer's The Most Good You Can Do

Coralie Oddy

This academic year, financial education was made part of the compulsory national curriculum in the UK for the first time [1].

 This is fantastic news for young people, but also potentially for effective altruism.Most effective altruists that I have met have a good understanding of finance and economics, which is unsurprising in a movement which seeks to do the most good by giving. However, to spread effective altruism on a large scale, we need to be mindful that large numbers of people have a poor understanding of personal finance.

The Financial Capability Report (2013) showed that 16% of people in the UK couldn’t read a bank statement correctly, while 30% of people couldn’t select the best out of three individual savings accounts. Less than half of those surveyed made a personal budget for themselves [1].

If you are worried or confused about your finances, giving is less likely to be on your agenda.

To give regularly and consistently, you need to be able to understand what you are able to give, and have confidence in your ability to manage your money. 

A population that can live well within its means, rather than a population with great wealth, appears vital for creating a culture of giving.

Of course, a good understanding of finance is likely to be beneficial in terms of confidence in the ability to give and in ensuring a potentially larger portion of income to give away in the future.

In one case study, students at sixth form college in Newham, an area of London with high economic deprivation [2], took courses in financial studies alongside their A-Levels. They displayed an awareness of risk and benefit in terms of loans and investments, with some students inspired to start their own business ventures or continue their studies in finance at university level [3].

There were also reports of students taking financial information back to their families, shaping their decisions on personal finance. This meant some families seeking financial advice or shopping around for accounts and insurance for the first time.

Clearly, teaching finance is beneficial on an individual level, but also benefits communities and family groups. While giving itself does not form part of the new curriculum syllabus, making it part of the picture could give these benefits a global reach, too.

With financial education now featuring on the curriculum, this could be an ideal opportunity to talk about how effective altruism can fit into a young person’s life plans.

Effective altruists could consider delivering school workshops and talks, or support young people to create their own effective altruist youth chapters. If you are a teacher, there’s a lot of potential for lively and exciting lessons that incorporate thinking about altruism. Organising debates about ‘how to rule the world well’ or asking students to work out and agree on how they would split their country’s GDP if they were in charge are appealing for young people and support speaking and listening, critical thinking and maths skills, while also helping young people consider their roles and responsibilities as global citizens. With the right facilitation, a debate like this could work even at primary level.

When I worked in education, the vast majority of young people I met were passionate about making a difference and doing something impactful with their lives – it was how to achieve this that posed the difficulty. Education on public spending provides an opportunity to address the inequality present in the world, and promotes active discussion about the most effective ways to change this.

Instead of allowing young people to believe that poverty is an insurmountable problem, we can provide them with the tools for change.

Research suggests that altruism and other sharing behaviours sharply increase during adolescence, but that parochialism – treating members in your own group or circle differently to ‘outsiders’ – also emerges at this time. In our teenage years, we are seeking to form our identity and develop an understanding of which groups we belong to, and therefore, who we should help and support in the future [4]. If we teach young people about their similarities and connection with other young people in the developing world, we promote inclusivity and empathy by extending ‘in group’ status at a time when young people’s ideas about this are still malleable.

talk to children about how their contemporaries in the developing world live, and model giving for them

. As a parent, giving children extra allowance to give to a good cause of their choice and explaining that’s what you do too is a great starting point for getting your kids to think about money management and get into the habit of giving.

Combine these early giving habits with a sound financial education, and we have a strong basis for a generation of potential altruists who are well informed, critical and confident.

if you work with children and young people in any capacity (or are a parent), start talking about giving now

. It really is never too early, and the benefits – an understanding of the value of money, compassion and sharing skills – are what we all want for our children.

If we want young people to make positive, impactful life choices, the best time to bring this up is when they are still in education. If we want them to give effectively in the future, we can give them these skills and values now.

Money advice service: press release on UK money habits

The development of egalitarianism, altruism, spite andparochialism in childhood and adolescence

Why financial education matters for smarter giving

Raffi Grinberg

The other patrons at the Chinese restaurant were beginning to stare. Charlotte and I couldn’t help raising our voices as the debate intensified.

“Isn’t the point to pick the charity that does the most good for the least amount of money? Each dollar that doesn’t go there is a dollar that could have done more good,” she asserted.

“Yes, but I guess there are two different values. Doing as much good as possible, and contributing to the survival of the Jewish people.”

We were at an impasse. We had agreed that, rather than using a gift registry for our wedding, we would create a charity registry. “We’ve been blessed by our families with more than enough furniture, clothing, and kitchen supplies to make a home,” we wrote in the invitation. But which charities would make the list?

Both Charlotte and I have become more passionate about advocating charities that are evidence-backed, and whose impacts are proven. To that end, we had identified 

, both recommended by the rigorous charity evaluator 

. It felt strange, though, to exclude Jewish charities—given that we were having an orthodox Jewish wedding.

Being Jewish is what shaped my views on charity in the first place. Growing up in day schools, my classmates and I were instilled with our people’s commitment to tikkun olam (repairing the world). We were encouraged to decorate our own tzedaka (charity) boxes, to take them home and donate a portion of our allowance each week. In Bible class, we learned about the tradition of the tithe, about how one tenth of our income belonged not to us, but to those who needed it most. And in Talmud class, we learned the importance of challenging the majority opinion, of demanding error-proof logical argument.

When I first heard about Giving What We Can—donating 10% of one’s income? using metrics to select the most effective causes?—it sounded like a Jewish organization!

On the other hand, there are ways in which my commitment to Judaism conflicts with my commitment to effective altruism. Most prominently, the fact that I choose to donate a portion of my 10% to Jewish charities that are not as proven as other secular charities.

Plenty of Jews give to non-Jewish charities, but Jews are much more likely to give to specifically Jewish charities. If Jews don’t support their own people, few other people will necessarily prioritize helping Jews over others. True, as Charlotte astutely pointed out, each $1 I give to a Jewish person in need could have helped a non-Jewish person who was more in-need, whose life could have been more improved by that help.

But I see a difference—it’s not just about the individuals. Unfortunately, as has often been the case in history, the existence of the Jewish people is continuously threatened. As a Jew, I feel a strong obligation to contribute however I can to our survival.

I’m able to apply the same standards I’ve learned from the Giving What We Can community to find the more effective Jewish charities. Unfortunately, I’m not yet aware of any large ones that track data through studies and emphasize transparency to the same extent as GiveWell’s top-rated charities, but I still seek those that save the most lives (or have the most positive impact on lives) for the lowest cost.

True, my allocation may feel contradictory, and it is a question I am still working on—by reading, by thinking, by debating with Charlotte and with others. What I’ve concluded is that it’s okay for now. To paraphrase the philosopher Rabbi Harold Kushner: if it were an obvious choice, if all our decisions of right-and-wrong were pre-programmed into us, life would have no meaning. Struggling with questions of morality is what gives us purpose.

How Religion Motivates My Giving

John Halstead

Public health interventions in the 20th century have been responsible for massive improvements in global health. According to the Copenhagen Consensus,

“Life expectancy hardly changed before the late 18th century. Yet it is hard to overstate the magnitude of the improvement since 1900, from a life expectancy of 32 years to 69 now, to 76 in 2050. The biggest factor was the fall in infant mortality.”[1]

68% of the improvement in human health is down to technical improvements, such as vaccines, micronutrient fortification and deworming medicine, while higher income accounts for only 3%. For example, Sub-Saharan Africa’s real per capita income in 2008 was just over half that of England in 1870, and yet child mortality rates are two thirds lower in Africa in 2008 than in England around 1870.[2]

Under five Years of Life Lost (YLL) as a percentage of total YLL 1990 – 2050.[3]

Many critics of aid[4] underestimate the sheer scale of the progress that has been achieved as a result of public health interventions, which are often supported by foreign aid and international bodies such as the World Health Organization (WHO), UNICEF and the World Bank. In this blogpost, I will briefly describe and assess some of the most successful public health interventions of the 20th century.

This research relies to a large extent on the prior work done in this area by the Centre for Global Development, which has been published as Millions Saved. We have selected four of the twenty case studies from Millions Saved, examined the evidence given, and tried to provide reasonable estimates of cost-effectiveness. In addition, we look at an intervention not covered in Millions Saved – reducing tuberculosis in south east Africa.

We have strong reason to believe that that all of the interventions had high impact and very high cost-effectiveness.[5] All of them averted a Disability Adjusted Life Year (DALY)[6] for less than $50, some of them significantly less, with smallpox eradication, for example, saving a life (30-40 years) for $5. For context: the NHS will spend £30,000 to save a Quality-Adjusted Life Year (QALY);[7] and the world’s most effective charities avert a DALY for around $30.[8]

The smallpox eradication campaign (1967-1979) is by some distance the most effective program considered here and is one of the best public health interventions of all time. In 1967, smallpox affected 10-15m people and killed nearly a quarter of them.[9] The eradication campaign, with the help of the WHO, the US government and endemic countries cost only $300m.[10] It has saved at least 50m lives until today and provided enormous non-life-saving health benefits.[11]

Cost per life saved (1967-2014) = $5 per life.

This suggests that the intervention averted a DALY for significantly less than $1. Indeed, the benefits mentioned here do not include non-life-saving health benefits, such as blindness prevented. The eradication of smallpox was a truly extraordinary public health achievement.

2. Guinea worm reduction in Asia and Sub-Saharan Africa

Giving What We Can views interventions against Neglected Tropical Disease (NTDs) as having high cost-effectiveness.[12] One NTD, which until recently blighted much of Africa, is dracunculiasis AKA ‘guinea worm disease’. Guinea worm is contracted by drinking water bearing the guinea worm parasite. The disease is rarely fatal, but it does impose a significant disability and pain burden on those infected. On average, the disease incapacitates people for 8.5 weeks.[13]

Blog

SCI in Madagascar

Why averting a DALY through deworming may be better than through malaria nets

Peter Singer's The Most Good You Can Do

Why financial education matters for smarter giving

How Religion Motivates My Giving

The Best Public Health Interventions of the 20th Century

Update on the Against Malaria Foundation

Giving What We Can Spring Fundraiser

Ten Swaps to help you get to your Pledge

Living on less than £1.50 a day