- In 1971, in East Bengal, millions are dying from lack of food, shelter and medical care
- These deaths are avoidable
- However, people have not taken the necessary decisions to avoid these deaths
- No government has given the sort of massive aid that is necessary to enable the refugees to survive for more than a few days
- Britain, among the top givers of aid to East Bengal will spend more than 30 times as much on the Concorde
- Australia, another top giver, will spend more than 12 times as much on the Sydney Opera House
- The way that people in affluent countries react to situations like the East Bengal crisis cannot be justified
- First assumption: death from lack of food, shelter, medical care, or other basic necessities are morally wrong
- Second assumption: if it is in our power to prevent this moral wrong from occuring, without sacrificing something of equal or greater moral importance, we ought take necessary actions to prevent that moral wrong
- These principles seem uncontroversial, but if acted upon they would change the world radically
- Distance doesn’t matter – helping a person 10,000 miles away is as important as helping a person 10 yards away
- Doesn’t matter if you’re the only person who can help or if there are millions of others who could also be helping
- Why should we refuse to take distance into account?
- If we accept the principles of impartiality and universalizability, we cannot discriminate against someone merely because they are far away
- It used to be possible to argue that you know the needs of the person who is close to you better, and thus are better prepared to help that person
- However, swift communication and transportation have obviated that argument
- Why shouldn’t it matter that there are millions of others in the same position?
- The fact that others have done nothing says nothing about our own moral obligation
- If everyone gave 5 pounds sterling to the Bengal Refugees Relief Fund, there would be no crisis in Bengal
- The fact that others won’t give 5 pounds means that you’re obligated to give more; by giving more, you’re doing more good
- Why doesn’t this become an infinite obligation?
- The infinite obligation paradox only arises if the act of sending money is simultaneous and unexpected
- If we build an expectation of giving, then no one has to give the maximum they’re able
- The outcome of this argument is that traditional moral categories are upset
- Normally, giving to international food aid is considered a “charitable” donation
- Charitable donations are “superogatory” acts – it’s good if you do them, but you’re not an immoral person for not doing them
- Singer redraws the boundary, making donating to food aid an obligatory act
- Is this too big a revision of our moral code?
- In the past, society drew a distinction between duties and superogatory acts in order to draw a line between behavior required for society to function and other other good behaviors
- However, the moral point of view requires us to look beyond our own society – the prevention of the starvation of millions is at least as important as the upholding of property norms within our society
- Is this moral code one that people are actually capable of upholding?
- Sidgwick and Urmson argue that we need to have a moral code that is not too far beyond the capacities of ordinary people
- Otherwise there will be a general breakdown in compliance with the moral code
- However, this ignores the amount of influence that moral codes have on social norms and personal behavior
- If the expected amount that one donates is 5% of one’s income, then the thought of giving away half of one’s income is absurd
- If there is a norm that no one can accumulate wealth until the least well-off are provided for, then only giving away 5% of your income will seem extremely narrow-minded
- Finally, this consideration only applies to what we expect from others, not what we should expect from ourselves
- There are number of other points, more practical than moral which have bearing on this issue
- Aid ought to be given by governments, not private charity
- Why not both?
- No evidence that private charitable donations reduce the probability of government aid
- Even if one is lobbying for government intervention, one should practice what they preach and give direlctlso
- Famine relief only increases the chance of starvation later, due to population growth
- This only means that aid should be targeted at population control, rather than famine relief
- The total aid donated should be the same
- How much should we be giving away?
- The strong version of Singer’s principle is that one should give until one has lowered themselves to the position of the person that they are giving to
- The weak version of this argument is that one should give until further giving would cause the loss of something morally significant
- Even the weak version of the argument requires a massive shifting lifestyles
- However, these considerations are academic, given that the amount we give is so far below even the threshold of the weak form of the claim
- Do philosophers have a role to play in public affairs?
- It is sometimes arguemd that public policy depends on assessments of facts, and because philosophers have no specific expertise, they aren’t qualified to comment on public policy
- However, the famine is not one of these issues
- The existence of the famine is not in doubt
- Nor is it disputed that Western societies can help, either through direct food aid or investment in population control
- Therefore, this is an issue in which philosophers can take a position
- The issue is one that is faced by anyone who makes more money than is necessary to support themselves
- It is not enough to discuss; one must also act to bring the practice of their lives more in line with philosophical theories
- Postscript
- While the famine in Bangladesh has ended, the world food crisis is, if anything even more serious
- US no longer has huge grain reserves
- Increases in the price of oil have made fertilizer and transportation more expensive
- The case for aid remains just as great in 1972 as it does in 1971
- However, instead of targeting direct food aid, we should target population growth reduction
- The important is to choose the most effective target and direct a massive amount of aid at that
- Introduction
- In 2013, nearly 800 million people were living under the international poverty line
- Living in poverty has a significant negative impact on health
- People die of easily preventable illnesses, such as malaria tuberculosis and diarrhoea
- This suffering is preventable but neglected
- The case for global health and development as an important cause area
- Global poverty creates a great deal of suffering for a great number of people
- In 2013, 10.7% of the global population lived under the global poverty line of $1.90 a day
- This line is the minimum level of income required to fulfill basic food, shelter and clothing needs
- These people are especially vulnerable to preventable diseases
- The damage done by these diseases runs into the millions of DALYs per year
- There are well documented ways of reducing poverty
- Poverty is relatively tractable if we focus on immediate costs to health and quality of life
- Relatively simple and cheap interventions can prevent infectious disease and parasitic illnesses
- Additional resources would do a great deal more in this area
- Global poverty gets a great deal of attention but the actual funding level is relatively small
- Both government and individuals allocate a relatively small number of donations to alleviating global poverty
- We have stronger evidence for interventions in global poverty being effective than in almost any other area
- Measurable outcomes
- Robust record of successes
- Certainty about actual benefit
- Cost-effectiveness analyses and RCTs
- Cost-effectiveness analyses attempt to quantify how much good can be done with a given amount of money
- For example: the eradication of smallpox saved at least 60 million lives at a cost of 1.6 billion dollars
- This works out to roughly $25 per life saved, which is amazingly cost effective
- The most highly recommended charities today save a life for $900 – $7,000, which is still pretty cost effective given that we spend far more to just add a couple of years to our lives in the developed world
- Cost-effectiveness estimates are based on randomized controlled trials (RCTs)
- Give intervention to half of the population, and have the other half as a control group
- Compare outcomes
- Interventions in global health are backed up by more RCTs than any othe cause area
- In summary, it’s possible to have a large impact on global health and development because:
- The problem is large in scale
- Many of the subproblems are highly tractable
- The problem is relatively neglected, given its scale
- The evidence for interventions is very strong
- Concerns about prioritizing global health as a cause area
- Does foreign aid really work?
- While some foreign aid interventions are wasted, the average dollar of foreign aid does a lot of good
- Even if all other foreign aid was wasted the eradiction of smallpox would have been worth it
- Charity “beings at home”
- Additional resources can do a lot more good per unit in the developing world than in the developed world
- Developing countries lack resources and their problems are ones that we’ve solved at home
- Who are we to say what poor people need
- It’s possible to intervene without being paternalistic
- Concerns about paternalism seem less pressing when people have clear and pressing needs
- Why you might not choose to prioritize this cause area
- There might be better ways to improve the lives of people living today
- Mental health problems might be causing more suffering than poverty
- Investing in a broader cause area might improve the decision-making of all humanity, improving our ability to solve not just this problem, but all problems
- We need to avoid the “streetlight fallacy” of investing in cause areas simply because it’s easy to build RCTs around their interventions
- We should prioritize reducing the suffering of non-human animals
- Over 50 billion animals currently live in conditions of extreme suffering before being slaughtered in factory farms
- There is even less spent on this than is spent on fighting global poverty
- Comparing the two depends on the following judgment calls
- The significance of animal suffering compared to human suffering – is human suffering more morally significant
- The indirect effects of poverty interventions vs. animal suffering interventions – do efforts to reduce poverty have more positive spillover effects?
- Importance of a strong evidence base – we have far more evidence that efforts to alleviate human poverty work
- We should prioritize the long-run survival of humanity
- If we think we can affect the long run future, focusing on that might have a higher impact than focusing on more immediate problems
- How much moral weight should we give future people
- How much weight should we give the “non-identity problem”
- Policies enacted today will determine what jobs and lives people have, who they marry, etc
- These policies will affect how good the lives of future people are
- How can we balance policies that cause future people to come into existence, but make them worse off?
- Can our actions have any impact on the far future
- Maybe the best way of fixing long-term problems is by fixing the short-term problems first?
- We might want to focus on systemic change
- Poverty reduction only addresses the symptoms of poverty, not its root causes
- Not clear whether focusing on the immediate issues will help us end poverty altogether
- Current marginal efforts are probably best spent helping the poor directly, rather than on politics
- Summary
- Global poverty causes a huge amount of suffering
- One of the worse consequences of this is preventable disease
- We have a number of highly effective interventions for treating diseases
- We have strong evidence that these interventions work and are cost effective
- It’s plausible that we should further systemic change to solve these issues
- However, systemic change might be best effected by giving local participants the ability to better influence their own futures
- Whether you believe this to be the most important cause depends on
- Whether you believe there are other better ways to improve human lives
- How much marginal value you give to reducing human suffering
- Whether you believe it more important to focus on the long-term future of humanity
- The top charities GiveWell recommends to donors are characterized by:
- Evidence of effectiveness
- Programs should be studied rigorously and repeatedly
- Benefits should be expected to generalize
- Can the charity execute?
- Cost effectiveness
- Estimate cost required to accomplish a particular benefit
- People in the developing world have a dramatically lower standard of living, so a single dollar can help them more
- Room for more funding
- Top charities receive a significant number of donations as a result of GiveWell’s recommendations
- Will these additional funds be well spent?
- Transparency
- Potential top charities are examined thoroughly and skeptically
- Charities must be open to this investigative process
- Why these criteria?
- Effectiveness
- Most information about charities is simplified, exaggerated or incomplete
- In order to judge what donation will do the most good, one needs to answer the following questions:
- What will the donation permit that would not have otherwise have happened?
- Will this activity change people’s lives for the better, or will it run into challenges
- Will it accomplish a large amount of good, relative to other possible donations
- While one can make an informed assessment of these questions by examining charities in detail, not everyone has the time to do this
- GiveWell focuses on charities that are verifiably outstanding, for whom a case can be made without relying on judgment calls
- Global poverty
- Developing world poverty is far more severe than developed world poverty
- Each dollar goes farther in the developing world
- Direct causes over root causes
- Root cause efforts require far more donor engagement
- Addressing direct causes can empower people to address root causes themselves
- Donors should focus on areas that they’re best able to help
- Why so few charities
- GiveWell focuses on a relatively small sector of the charitable sector
- Only assesses charities that publish the statistics that allow them to be assessed
- Evaluation is time-intensive
- The process for identifying top charities
- Find eligible charities
- Search for charities
- Look at applications
- Examine charities
- Deeply examine charity’s impact
- Find out strengths and weaknesses of charity
- Follow up
- Track performance over time
- Write about both positive and negative outcomes
- 3 top charities whose goal is reducing deaths
- Malaria Consortium’s Seasonal Malaria Chemoprevention (SMC) program
- Helen Keller International’s Vitamin A Supplementation (VAS) program
- Against Malaria Foundation (AMF)
- 5 charities implementing programs to increase income
- Evidence Actions’ Deworm The World Initiative
- Schistosomiaisis Control Initiative
- Sightsavers’ Deworming Program
- EDN Fund’s Deworming Program
- GiveDirectly