Climate Change (in progress)

Written By JD Bauman

Full Report

JD + Team to do:

  • Wait until further instructions (JD waiting on Shilpita to see profile approach)

Report depth

Intermediate

Note: This research draws heavily from a post by Rob Wiblin at 80,000 Hours. See their up-to-date entry here.

Our overall view

Very often recommended. We think most of our readers should consider working on and/or donating to this issue. For a summary of why see our profile summary.

Where is our evidence from?

We draw on research from Oxford’s Gobal Priorities Project, 80,000 hours, GiveWell, and the Copenhagen Consensus. Our recommendation is based on their findings, as well as basic data from the Global Burden of Disease and World Bank, among others.

What is the problem?

Every year around ten million people in poorer countries die of illnesses that can be very cheaply prevented or managed, including malaria, HIV, tuberculosis and diarrhoea. Tens of millions more suffer from persistent undernutrition or parasitic diseases that cause them to be less mentally and physically capable than they otherwise would be.

Why is it pressing?

These diseases cause unnecessary suffering and death both to victims and their families. They also lead to a range of other negative effects:

  • Lower educational attainment.

  • Lethargy and reduced ability to think and work.

  • Worse health later in life.

  • Higher birth rates to compensate for infant mortality.

Schistosomiasis affects over 240 million people each year. It and other parasitic worms cause fever and diarrhea and also affect educational outcomes. Infected schoolchildren are more likely to want to stay home due to feeling sick or embarrassed by their symptoms.

In many cases these diseases or their impacts can be largely eliminated with cheap technologies that are known to work and have existed for decades. For example:

  • Schistosomiasis and other parasitic diseases can be cured with a pill that costs under $1 a year.

  • Malaria is prevented by insecticide-treated bednets.

  • TB is almost always cured by sustained treatment with antibiotics (so called DOTS).

  • People with HIV live nearly normal lifespans, and rarely pass on the virus to others, if promptly and consistently treated with anti-retroviral drugs.

  • Diarrhoea can be prevented through better sanitation, and death prevented by oral rehydration therapy.

  • A range of other diseases can be prevented through basic vaccination programs (e.g. diphtheria, whooping cough, etc).

While the cost-effectiveness of the above approaches ranges quite widely, they can in most cases generate an extra year of healthy life for under $1,000, in a few cases for less than $100.

Over the last 60 years, death rates from several of these diseases have been more than halved using these techniques, suggesting a very clear way to make progress.

Where is this problem most relevant?

The greatest need remains in the global south, especially in sub-Saharan African countries. One of the worst preventable diseases (measured by total lives lost) is malaria. In 2020, malaria caused 626,000 deaths worldwide, almost none if which occurred in western countries including the United States, which eradicated the disease in 1951.

The vast majority of malaria deaths (and deaths from other easily preventable diseases) occur in the global south, especially in Africa.

What are other arguments against it being pressing?

  • You might think that it is not a particularly neglected problem, given it is very widely recognised and is funded by organizations, including aid agencies, with billions of dollars to spend each year. Governments in developing countries are also making significant progress in improving health, although some gaps certainly remain in practice. In this view it will be hard to find exceptional opportunities because there are so many other people trying to do so.

  • You might worry that reducing poverty and improving health in poor countries will not have major long-run effects on the future, which will instead be determined in other ways, for example through war or the invention of new technologies.

  • You might think that other means for reducing poverty will be more effective, such as reforming government and legal institutions in developing countries.

Key judgment calls to prioritise this problem

  • That the lives of people in other countries are not much less important than the lives of people in the country you (probably) live in.

  • That improving health will cause developing countries to become sustainably richer and nicer to live in, for example by reducing fertility or improving education and governance.

What can you do about this problem?

Is there a big difference in impact between different interventions?

  • There exist well-documented differences in impact between various global health interventions.

A comparison of 108 different health interventions by their cost-effectiveness, measured in disability-adjusted-life-years (DALYs) and adapted by Toby Ord (Dean Jamison, et al. 2006).

What’s most needed to contribute to this problem?

Deliver basic health services to all people who have or are at risk of contracting easily prevented contagious diseases. For example:

  • Get all children to receive the basic schedule of vaccinations (currently around 85% do). [1] (Listen to 80k’s 2021 podcast with Varsha Venugopal about recent work in this space.)

  • Get everyone exposed to malaria sleeping under bednets. Currently a bit over half of people in the relevant parts of Africa have access to bednets. [2]

  • Get all TB cases treated – currently at least a third are not diagnosed. [3]

  • Ensure everyone has access to clean drinking water – currently at least a billion people do not.[4]

This is primarily a funding and logistical issue. The treatments are usually simple and do not require advanced medical training to deliver (though treatment of TB and HIV requires medical oversight).

What skill sets and resources are most needed?

  • The ability to fundraise large sums, or move money within bureaucracies to better projects.

  • People with on-the-ground logistical skills in international development (i.e. the kind of person who could get 100,000 malaria nets distributed in Africa).

  • Entrepreneurs (mostly in nonprofits but also sometimes for-profits) who could found one of these charities.

  • Development economists and cost-effectiveness researchers, including economists, statisticians and disease control experts.

  • Money to fund GiveWell recommended charities.

We think that people capable of starting outstanding projects in this area are likely to be able to attract the necessary funding, making the area mostly talent constrained.

What orgs are working on this problem?

What can you concretely do to help?

Some recommended organizations

Who are some Christians in the CFI network working on this?

  • Adam Winnifrith, a master’s candidate at Oxford University, working on anti-microbial resistance.

  • Ana Karina Pitol, a research associate at the Liverpool School of Tropical Medicine.

  • Katie Fantaguzzi, a senior M&E advisor at the SCI foundation.

  • Various economists studying global development and health.

  • Various others who earn-to-give.

Interested in talking to someone about tackling this problem with your career?

Sign up for 1-on-1 mentorship. We’ll pair you with a Christian who can talk to you about how to make an impact in this problem area.

JD Bauman
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