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Rob Wiblin

 interviewed GiveWell co-founder Elie Hassenfeld (pictured right) on a range of issues suggested by volunteers and members of Giving What We Can. This is the first instalment, focussed on the issue of meta-charity - or research into which forms of charity are most effective.

An unabridged transcript of the interview is available 

RW: Do you think there’s any chance that giving to organisations that research which interventions and organisations are most cost-effective, such as GiveWell, but also other research outfits like the 

 and so on could have a greater impact with each dollar than the organisations that you actually recommend?

EH: It’s definitely possible, I think it’s an interesting question. 

 (IPA), one of the organisations you’ve listed in the past. Our view is that, the organisations that we rate most highly right now, Against Malaria Foundation (AMF), Give Directly and the Schistosomiasis Control Initiative (SCI), are all better bets than IPA. We’ve definitely thought a lot about funding research, we’ve talked about this in the context of this cause of meta-research.

We’ve talked about this part of GiveWell Labs that would be funding a group like the 

. We’ve also thought about funding randomised controlled trials (RCTs) themselves. There’s questions involved there; the research we found in our work is actually more the research done by the global health community. That would be groups that are performing the RCTs on malaria nets, water and nutrition trials. That’s work that we’ve found really helpful.

I do think it’s interesting that people ask us about funding research or meta charity, and they tend to focus on the groups that are more visible, the groups like IPA or Jameel Poverty Action Lab, and less the groups that I think have been most helpful to us, which is just the general global health research. The other group that’s been incredibly valuable to us is the work done by literature reviewers broadly and the Cochrane Collaboration specifically. That’s a group to which we directed what we call a quick grant about a year ago and we are interested in what they do and have been following that.

RW: So did you manage to find any organisations that were doing that basic health research, who you could potentially fund?

EH: My impression is that a lot of that research comes from broader academic departments. There are researchers at universities working in the World Health Organisation. This is the type of thing where the type of groups to which an individual donor can write a check and cause something to happen may be different than the opportunity for a larger funder to fund a specific project. And that distinction is one that is becoming particularly salient to us as we think about the move from our traditional focus on direct aid-providing organisations, to other areas where we almost want to be thinking more like a major philanthropist. And so I think that thinking how to fund RCTs or global health research will likely be done more in the vein of here is an RCT that we find particularly valuable, so we’re going to go and identify the funding to implement this RCT and then provide it all in one go, rather than giving more money to organisations to support RCTs more broadly. Obviously one can do that for IPA and then all of the questions you want to ask are the ones that we discussed in our review of IPA.

RW: Sure, so did you have much success finding out whether these kinds of meta-charities were having influence on [government or charity] spending. Was that something that was possible to identify?

EH: It’s tough. I mean, IPA is the one we’ve looked at the most and we have a whole page up on them, about our best assessment of the impact that their research they’ve done has had on the conversation. The studies that seem most impactful to us are studies on deworming, studies on free bednets, the studies they conducted on microfinance. That does have an influence. Without a doubt, other trials have had an influence. I don’t think this is the type of thing where it was easy to possible to perform a very direct and obvious case of the exact nature of the influence that they had.

RW: Have you found organisations receptive to getting that kind of tied grant to perform a particular RCT or a particular literature review. Is that something that donors like our members should be thinking about trying to pursue?

EH: I think it’s difficult to pursue on their own. So this is just my general impression and I can’t promise you that this is 100% correct, but my impression is that a great deal of individual RCTs are funded by donors who are reasonably restricted with their grants. So it’s possible for them to say ‘I want to fund a study on water in a particular area, with a particular technology’; so that would be very restrictive. I could also imagine a funder providing a great deal of money for many RCTs somewhat related to - let’s say - water. So I think that is incredibly common as a model for false plunders: providing money for research.

I think it’s not a thing that makes a lot of sense for individual donors to be trying to do on their own. Depending on the study, studies can cost half a million dollars. So if you’re a donor with five thousand dollars, you’re not able to make a study happen with just that money and if you really want to give to this, you need to look to someone who can aggregate up the funds. Now this is something we’ve thought about doing. I think, down the line, GiveWell will do this. Essentially provide the mechanism by which individuals who want to provide to a larger pool of money that goes to things that those individuals couldn’t otherwise afford, we’ll provide the vehicle for them to do that - not something that exists right now.

All that said, I just want to take a step back. I think there’s a lot of reasons that research could be among the best things. At this stage in time, you know, I haven’t found any research that is right now obviously competitive with AMF. I think it’s important for anyone who’s thinking about this to not just think about the conceptual case that research could be good, but to try as hard as they can to nail down the specific organisation or the specific research that they want to do, and think about how that would trade off against giving to the top performing organisations.

There are two additional thing to be aware of when it comes to research. One is when we look at studies, often what we find is something goes wrong that diminishes the amount of information that the study can convey. So recently, we’ve been looking at some clean water trials. And this is a page that we’re trying to publish shortly. So these are studies of water purification technology. Basically, giving some people a filter, don’t give some other people the filter, then measure what happens to the water quality, measure what happens to health outcomes. In some of these studies, what happened is that the control group water filter actually causes the water to purify to some extent and this diminishes the power of the study to communicate results. One challenge of conducting studies is that you can conduct them, but there may be some problem in their implementation that reduces the impact.

Another issue to be aware of is that a single RCT is not particularly informative. And the programs that have the strongest evidence have multiple RCTs behind them. For example, malaria has tens of RCTs showing impact of nets on malaria, and so to get to the point where one has this body of knowledge that enables them to have a strong view about the impact of a program requires more than just funding a single trial.

All of that said, this remains an area that we, GiveWell, are very interested in considering, and I think it’s something we’ll be doing in the next few months. If we find the areas where research might have the biggest impact, that’s something we’re definitely considering trying to provide funding for.

Interview with GiveWell: Should we be funding research?

Diana Fleischman

A guest post on the flow-on effects of better health on individual behaviour and society as a whole, from 

Evolutionary Psychologist Diana Fleischman

 at the University of Portsmouth, who recently joined Giving What We Can.

Curing and preventing disease can alleviate suffering and increase quality of life in the developing world in the short term, but reducing the burden of infectious diseases promises even greater long term benefits to individuals and society than you might think.

 describes psychological and biological changes that prioritize the short term over long term when there are early cues of a harsh and unpredictable environment. Cues of volatility such as parental absence or poor nutrition caused by infectious disease and poverty can change the psychology of a whole society. Removing these cues might have a significant impact on wellbeing.

In evolutionary terms, the goal of every organism is to have as many of its genes in the next generations as possible. Every organism has a limited amount of energy to allocate to activities such as bodily maintenance, growth and mating, each of which can contribute to successful reproduction. There are a number of different strategies that might increase the likelihood of success. You can grow large, or you can get to sexual maturity as quickly as possible. You can put energy into healing injuries, or into finding partners to mate with. You can have few offspring and try to make them as healthy as possible, hoping that they will be more successful as a result, or you can have a large number of offspring and invest little in each one, hoping that at least some will survive. Those strategies that prioritize maturing and producing many offspring quickly, are called "fast life history" strategies.

The success of different strategies is going to depend on a number of factors. One of the most important is how long an organism has left to live, and a good cue of this factor is the mortality of those around you. Researchers have found that environments which are unstable may cue a fast life history. In other words, these cues indicate to the organism that it is best to follow a strategy of reproducing sooner rather than later, because they could die at any moment. A fast life history strategy involves earlier sexual maturation, earlier sexual intercourse, greater number and less investment in offspring. This is because in a volatile environment where people die due to random events, success becomes a matter of luck rather than skill, and so it makes sense to have lots of kids rather than invest heavily in just a few 'highly skilled' ones. Furthermore, the time available to reproduce and rear offspring is limited, so you have to hurry. There are other characteristics associated with a faster life history that I'll discuss in more detail later in this post.

It's important to note that changes in life history occur both over generations and an individual's lifetime. For instance, over time a species that is less often eaten by predators may evolve to reach sexual maturity later, or have larger and fewer offspring. Humans have had a long history of living in diverse environments, as well as having an extended developmental period. Thus we 1) have a long period in which cues about the difficulty of the environment can change our reproductive outcomes and 2) we may have evolved to be especially sensitive to these cues. Cues such as early stress, father absence and nutritional scarcity have been associated with faster sexual maturation, earlier sexual debut, greater number of sexual partners, greater number and less investment in offspring in a variety of species including humans.

Here are a few examples of environmental cues and changes that are relevant to reproduction:

 in early sexual maturation when adults die due to an infectious cancer.

In women, father absence and parental separation predict earlier age of reproduction, earlier onset of sexual activity

, earlier age of first period and shorter duration of marriage (controlling for economic factors and mother's behavior).

Father absence in boys predicts earlier puberty and earlier reproduction. Being breastfed for less than one month predicts earlier marriage and reproduction.

Girls from the developing world adopted into affluent Western families have an earlier age of first period than

Among hunter gatherers and subsistence farmers "

age at first period and age at first birth each occur about 1 year earlier for every 10% decline in child survivorship to age 15"

Some studies in the developed world have shown faster life history in those with 

. However, in the developing world fewer studies have been conducted on life history. One notable exception is a 

 showing that as pathogen stress (defined as presence of 7 different diseases or infections including malaria and leishmaniasis increased, father involvement (defined as father proximity to infant and father involvement in infancy and early childhood) decreased. In other words, fathers may be putting more time into having more offspring rather than investing in existing offspring when there are more pathogens in the environment. The same study found high levels of pathogen stress were associated with lower maternal care (e.g. mother proximity to sleeping infant) and earlier age at weaning.

Faster life history doesn't only influence reproductive characteristics but also influences personality and social characteristics. Monkeys exposed to variable feeding environments from infancy were less social and more timid than those exposed to 

more consistent and resource rich environments

. Fast life history has also been associated with steep discounting (the prioritization of current over future rewards), greater impulsivity and greater risk taking with regard to resources (see 

). Faster life history strategy has been associated with greater 

. These latter links are more tenuous but when faced the likelihood of a small time window it's smarter to take risks for immediate gains rather than playing a safer strategy. It's also smarter not to trust others who are likely adopting a similar strategy of taking greater risks.

Thus, reducing pathogen prevalence and disease burden may change cues of environmental harshness and unpredictability such as father presence, maternal investment, and age at weaning. Those developing in environments in which disease burden is reduced may change psychologically such that they reproduce later* and invest more in their children, engage in less risk taking and prioritize future over present rewards. This more patient and cautious approach to life, which will include fewer and better cared for children, obeying the law, and investing more in long term gains including cultivating skills and assets, could reasonably be expected to have an impact on economic productivity and people's incomes. However, it is hard to quantify how much given existing evidence.

In the next blog I'm going to review the 

 , the idea that parasite prevalence influences population characteristics such as proportion of personality types, religiosity, crime and ethnocentrism.

*One wrinkle in this is that women in the developing world may not be reproducing at rates consistent with a fast life history strategy because of inadequate nutrition. Some women in the developing world have been shown to ovulate less and 

have lower progesterone than women in developed countries

Die young and live fast

Yuan Yang

It doesn't only matter what you say, it matters how you say it. This is just as true when trying to persuade others to moral action. In this two-part series Yuan Yang will highlight the importance of conveying information persuasively when discussing moral issues. In her first post, you can read about how framing determines the moral content of your message, and why this matters for the DALYs per Dollar debate. Keep an eye out for Yuan's next post where she'll discuss representing statistics and the international Dollar vs real Dollar question.

To change the world, your words must be read and understood. Unfortunately, attention is a very limited resource - the attention of important decision-makers especially so. To make sure that our research on cost effectiveness is itself effective we need to write for our audience in the following ways:

Write a short executive summary that points out the decision-relevant findings for the target audience;

Include figures that highlight the large differences between different projects, and and which projects are the most important to pursue;

Get a visual designer to make your reports look professional and inviting to read

Potentially write different summaries for different groups: donors, charities, governments, the media, and so on;

Include clear but brief explanations of the key concepts, like DALYs.

A failure to do these things can cause good research to go unread and fail to contribute to a better world. 80% of your impact may come from a glossy executive summary, so it deserves a great deal of attention.

When we attempt to persuade others to moral action, the way we convey information matters - this we all know. However, moral persuasion is not just a matter of making information easy to understand, but also being aware of the 

When we write coherently, we cannot help but present our reader with a narrative, or what the professor of political communication, Jim Kuypers, calls a ‘frame’. "Framing is a process whereby communicators, consciously or unconsciously, act to construct a point of view that encourages the facts of a given situation to be interpreted by others in a particular manner. Frames operate in four key ways: they define problems, diagnose causes, make moral judgments, and suggest remedies. Frames are often found within a narrative account of an issue or event, and are generally the central organizing idea." (from Kuypers’ “Rhetorical Criticism: Perspectives in Action”.) Effective and ethically sound writing requires us to consciously choosing our frame and take responsibility for our rhetoric.

Let’s illustrate this with an example. Say you are showcasing three charities (A, B, and C working in the field of Neglected Tropical Diseases (NTDs), and you have DALY cost-effectiveness data on each of them. You are trying to convey two messages at the same time: firstly, that charity A and B are incredibly cost-effective compared to C, so you should prioritise A and B over C (the “effectiveness” message); secondly, that A and B are so cost-effective for achieving moral ends, that you ought to consider giving money to them (the “ethical impact” message). How do you prioritise these messages, and how do you convey them using your data?

When you present cost-effectiveness data, your choice of how to frame your data reflects your prioritisation of these messages, which in turn reflects moral values that will be implicitly understood by the reader. Consider the following:

“Charity A’s intervention costs $200 per DALY. You can find a brief explanation of DALYs 

. However, Charity B costs $250, and Charity C costs $20,000.”

This dollar-per-DALY framing of the information concentrates the reader’s attention on the dollar cost of DALYs saved. The problem with doing so is that it works for the reader who is straightforwardly minimising their expenditure per DALY, and just needs to see the smallest figure to decide where to give money. Most readers outside of the Giving What We Can community are not doing this.

“For $1,000, Charity A can save 5 DALYs. In comparison, Charity B can save 4 DALYs - but Charity C only saves 0.05 of a DALY.”

This DALY-per-dollar framing concentrates the reader’s attention on what it is the charities are doing - saving lives. This framing appeals to a reader who, like all of us, have money they could use in a variety of ways, but did not consider or realise the impact they could have by spending money on this particular charity.

Your aim should be to leave the reader feeling more optimistic about their ability to affect the world around them, and empowered to make decisions with better information; not harangued or guilty. Thus framing the information in terms of maximising a positive thing - the effect one can have - rather than minimising a negative thing - the cost of doing good in the world - emphasises the power of action. The problem with emphasising the “effectiveness” message is that it is implicitly appealing to only one moral intuition - some form of consequentialism. One does not have to be a consequentialist to think critically about where one’s money goes and what it does. No effective campaign for charitable giving should turn away non-consequentialists.

The DALY-per-dollar framing also avoids another illusion. Imagine you are comparing between three different projects, one that achieves $1/DALY, a second that achieves $3/DALY and a third that achieves $7/DALY. When comparing projects in $/DALY it is natural to think that the difference in value between the second and third (apparently $4/DALY) is more important than the difference in value between the first and second (just $2/DALY). In fact the opposite is the case, as revealed by their respective values in DALY averted per $1000 spent: 1000, 333 and 143. The difference in the good done between the first two options is 3.5 times larger than the difference between the second and third! A DALY/$ measure understates the real-world importance of apparently ‘small’ differences in cost effectiveness among the best options.

Keep an eye out for Yuan's next post where she'll discuss representing statistics in graphs and whether it is better to use international dollars or real dollars as your metric. (Ed.)

How to Present Statistics to Donors (Part I: Framing)

Krisztina Csortea

If you're in London this weekend, don't miss the Big IF, the Enough Food If campaign's rally in Hyde Park on 8 June.

On the same day as the PM holds the International Hunger Summit, you can take part in the rally and demand action on hunger from the G8.

According to the organisers, the line-up will include effectiveness pin-up and 

 Bill Gates, the outspoken former head of the Church of England, Rowan Williams, and other celebrities from sport and TV.

) on the effectiveness of campaigning for increased aid - we're pretty uncertain of its value - but the Enough Food If campaign is also about governance issues: land, tax and transparency. It's an interesting example of hundreds of NGOs coming together on one campaign platform - last seen on this scale in the 

Whatever its effectiveness, the rally at least promises to be an inspiring way to spend a sunny Saturday. There's another rally in Belfast on 15 June. This is all timed to coincide with the UK Government's hosting of the 

 in Enniskillen, Northern Ireland on 17-18 June, which Prime Minister Cameron has said will focus on tax, transparency and trade.

If you do go check out the rally, let us know how it went down!

What do you get when 30,000 people rally in London's Hyde Park?

Jacob Trefethen

Jacob Trefethen, of GWWC: Cambridge, details his experience with two types of Giving Games and their use in spreading the word about making smarter charity choices. His experience suggests that the games are a great way to get people thinking about effectiveness, for three reasons: (i) it's not their money they're forking out, (ii) direct comparisons are made between just two charities, encouraging rigorous debate, and (iii) it's actually pretty fun.

Giving What We Can has only been around for a few years, and the idea of choosing a charity based on its cost-effectiveness is still one many people have never consciously considered. Part of having a big impact is not only donating to the most effective charities yourself, but getting others to make their giving decisions more rationally. If you can get lots of people to change the way they think about charity, your impact could be 

But how can we do this? One inventive way to get people to think more strategically about charity decisions is to make a game out of giving. In the Giving Games run by 

, a pot of money is provided by an anonymous donor, and participants are presented with a choice of two or three charities where the money can go. After hearing some information about each charity and discussing the options, they then cast their vote. The charity with the most votes wins the pot.

Giving Games are a great way to get people thinking, as they are completely frictionless. Since (i) it is not their own money they are having to fork out; and (ii) there are only a couple charities they are allowed to choose from, participants have nothing stopping them from thinking very clearly and doing a direct comparison between the charities. Taking part in the game is also pretty fun.

, they can also take physical form. I am involved in the GWWC: Cambridge chapter, and we have run two Giving Games in the last few months. Here's what happened.

Giving Game 1: Schistosomiasis Control Initiative vs. Wikimedia Foundation

We staged this game at a stall in the foyer outside a conference on Higher Education. Every hour or so there would be a 15-minute break between sessions of the conference, where attendees would mill around with not much to do but chat. Due to the nature of the conference we picked two charities whose work has a large impact on education: Wikimedia is the foundation that funds Wikipedia, whose aim is to provide free knowledge to anyone with an internet connection, while Schistosomiasis Control Initiative (one of GWWC's 

) cures children of parasitic worms, thereby increasing school attendance in the areas it operates.

The game worked as follows. We gave a penny to each person who approached the stall. This penny represented their vote: for each person who voted, the anonymous donor would donate £2, and if more than 50 people voted there would be a bonus of £250. Participants cast their vote by dropping their penny into one of two jars sitting in front of the charity of their choice. Whichever charity had the most pennies in its jar by the end would get the whole haul.

Since the choice involved one very well known charity, Wikimedia, this allowed us to attract people's attention and then tell them about the lesser known one, SCI. It also meant that they had some initial interest in the decision - for example, a few people mentioned how they had given to Wikimedia as a result of its banner advertisements in the past, and were now consciously considering the effectiveness of their contribution for the first time.

The idea was not to get people to arrive at the 'right answer'. Rather, it was to get them to think carefully about what the relevant considerations were that would lead to making a decision. It was very interesting to hear what people thought these were.

Here is a sample of some reasons that participants wrote down for voting the way they did:

'No one else does what Wikimedia do - while SCI are very important, organisations such as WHO already do good work in this field.'

'Because Giving What We Can and indeed all charities operate by informing people about global issues. Information makes people likelier to give to charity in the first place - wider impact!'

'Wikipedia is brilliant but I think the priority has to be offering children basic good health & education (without which they couldn't access the information on wiki!)'

'Wikimedia would potentially be able to attract funding more easily.'

'[SCI offers] a more direct improvement in quality of life.'

One conversation with a passing student started very normally: he asked what was happening at the stall, we explained the premise and a bit about each charity, then asked him how he thought he'd go about making the decision. He then proceeded to fret, and stayed at the stall for 10 minutes, talking through the different considerations in favour of each charity with us and often staring at the ceiling in thought. He finally cast his vote for SCI, and wrote a paragraph summarising his reasons, ending with: 'I'm really unsure about this decision'.

We were impressed by just how much people were willing and keen to engage with the activity, and think seriously about where to cast their vote. This was the point of the exercise; not just to get as many pennies as possible into a jar.

52 people cast votes. There were around 110 people at the conference, so over the course of the afternoon around half of all attendees took part!

£354 was donated to SCI! (£2 * 52 + £250)

Giving Game 2: Against Malaria Foundation vs GiveDirectly

 duke it out against each other. The format of the event was very different. This game took place in the evening, with more time for presentations of each charity, arguments on either side, and discussion.

Introduction to idea behind Giving Games and to the structure of the evening by our moderator, then President of GWWC: Cambridge.

charity assessment module from The High Impact Network

. One of the team presented participants with three neutral descriptions of social interventions that have been implemented in the past, and asked them to consider whether they thought the intervention had a positive effect, negative effect, or no effect. A show of hands was taken for each option, and then the actual effect of the intervention revealed. This encouraged participants to reflect on the reliability of their intuitions in assessing charities, and broke the ice before our main charities were presented.

Presentation of charities, AMF and GiveDirectly. Four of our committee members split into two teams and acted as 'charity representatives', presenting information about 'their' charity and making the case for why it should get the vote.

Wine, nibbles, and informal discussion of what had been heard so far.

Questions and discussion. Our four 'charity representatives' took questions from the audience, transitioning into a more fluid discussion between all participants.

Vote! Participants filled out ballot slips asking them for both their choice of charity and a reason.

Blog

Interview with GiveWell: Should we be funding research?

Die young and live fast

How to Present Statistics to Donors (Part I: Framing)

What do you get when 30,000 people rally in London's Hyde Park?

How Giving Games can spread the word about smarter charity choices

Every. Last. Child.

Is it good to campaign for increased government aid to cost-effective interventions? Part 2

Peter Singer: The why and how of effective altruism

Living on $1.25 a day - what does that mean?

Hilleman Laboratories: A potential answer to the inequity in vaccine need and vaccine supply?