According to the most rigorous estimates, the cost to save a life in the developing world … is a small enough amount that most of us in affluent countries could donate that amount every year while maintaining the same quality of life … Through the simple act of donating to the most effective charities, we have the power to save dozens of lives. That’s pretty amazing.
Will MacAskill, Doing good better
1. Introduction
This is Part 2 of my series Getting it right. This series highlights ways in which effective altruists think and act admirably.
Part 1 discussed altruism. We saw in Part 1 that many effective altruists donate large parts of their income to charity, and some go further by risking their health in challenge trials or even donating organs to total strangers.
Today’s post discusses another area in which effective altruists have made great strides: global health. Much of what first attracted me to working with effective altruists was their commitment to effective solutions to pressing global health problems. That commitment continues to pay dividends to this day.
2. Evidence
It is easy to forget that just a few decades ago, the concept of evidence-based philanthropy was relatively marginal. More to the point, many of the chief advocates of evidence-based philanthropy were engaged in relatively shallow versions of the practice.
Consider, for example, Charity Navigator. Founded in 2001, Charity Navigator evaluates charities along four dimensions: accountability and finance, leadership and adaptability, culture and community, and impact and measurement. The first three of these dimensions could be well-satisfied by a transparent and well-led organization for effective basket-weaving, regardless of its importance for the world. What about the last?
Certainly it helps to assess impact, and Charity Navigator assesses impact along a number of criteria including the collection and analysis of data and the impact produced by each dollar spent. But what exactly does impact mean? Is weaving a basket more valuable than saving a human life? On this question, Charity Navigator largely demurs. In 2013, the CEO of Charity Navigator railed against effective altruism for the sin of:
Weighing causes and beneficiaries against one another. In this, it is not moral, but rather, moralistic in the worst sense of the word.
Effective altruists might be forgiven for their emphasis on the importance of careful moral theorizing coupled with evidence-based assessment. It is not only important to measure the outcomes produced by an intervention and the cost of producing them, but also to think carefully about what those outcomes mean and how valuable they are. Effective altruists were among the first movements to do this, and their legacy of combining evidence-based evaluation with rigorous moral theorizing leaves a persistent mark on philanthropy to this day.
For example, the founder of Inside Philanthropy, David Callahan, tells the MIT Technology Review that effective altruism:
Has been an overdue, much-needed counterweight to the typical practice of elite philanthropy, which has been very inefficient.
And indeed, early critics of effective altruism criticized the movement for having, if anything, too high standards of evidence. An influential review of Doing good better by the philosopher Amia Srinivasan worried that radical systemic changes would be neglected by effective altruists because they could not be quantified and evidentially analyzed in the same way as more immediate interventions:
What’s the expected marginal value of becoming an anti-capitalist revolutionary? To answer that you’d need to put a value and probability measure on achieving an unrecognisably different world – even, perhaps, on our becoming unrecognisably different sorts of people. It’s hard enough to quantify the value of a philanthropic intervention: how would we go about quantifying the consequences of radically reorganising society?
Longtime readers may know that I do not always think effective altruists have lived up to their commitment to use reasons and evidence to set global priorities. But I do think that they are trying to do this, and that at least within the arena of global health, they have often succeeded. That is better than many others can say, and certainly no effective altruists would outright urge the abandonment of reasons and evidence in prioritization decisions.
3. Efforts to date
Much of the public discourse around effective altruism can give the impression that the movement has shifted to a sole focus on longtermism, and in particular on threats raised by artificial intelligence. Certainly there is some truth to this thought.
A number of effective altruist organizations have made substantial shifts towards AI. 80,000 Hours has shifted its strategic focus to AI, announcing that they will “be hugely raising our bar for producing new content on topics that aren’t relevant for making the transition to AGI go well.” The Legal Priorities Project has rebranded as the Institute for Law and AI. This shift is marked enough that a very popular recent EA Forum post complains:
There’s a trend towards people who once identified as Effective Altruists now identifying solely as “people working on AI safety.” For those in the loop, it feels like less of a trend and more of a tidal wave. There’s an increasing sense that among the most prominent (formerly?) EA orgs and individuals, making AGI go well is functionally all that matters. For that end, so the trend goes, the ideas of Effective Altruism have exhausted their usefulness. They pointed us to the right problem – thanks; we’ll take it from here. And taking it from here means building organizations, talent bases, and political alliances at a scale incommensurate with attachment to a niche ideology or moralizing language generally.
However, what is not often remarked is that a very large amount of effective altruist funding has gone and continues to go towards short-termist causes such as global health.
Here is a breakdown of funding by cause area due to Tyler Maule:
This funding easily exceeds a billion dollars for global health causes. Indeed, Open Philanthropy alone has issued over a billion dollars of grants for global health and development. Combining this with an estimate of around $5,000 needed to save a life from malaria today yields an estimate of perhaps 200,000 lives saved, or the equivalent in QUALYs through other global health interventions. This is a very large number.
Even while many effective altruist funders have begun to throw traditional global health charities under the bus, they have often invested in other global health causes. For example, Open Philanthropy slashed its funding for GiveWell only to emphasize a number of new areas including a new fund aimed at mitigating the effects of lead poisoning and a more general turn towards meta-level global health interventions. I cannot say that I approve of these changes, but it would also be patently unfair to view them as a wholesale abandonment of global health, an area in which effective altruism continues to be one of the leading funders.
4. Continuing efforts
Effective altruists and their allies continue to spend hundreds of millions of dollars on evidence-based global health solutions.
Open Philanthropy has committed one hundred million dollars towards GiveWell’s activities in 2025.
GiveWell itself expects to raise over five hundred million dollars this year.
The Lead Exposure Action Fund, co-founded by Open Philanthropy in 2024, has committed over one hundred million dollars to date. This continues Open Philanthropy’s commitments to a new focus area in Global Public Health Policy launched in November 2023.
On a smaller scale, Open Philanthropy has made multiple seven-figure grants for vaccine development in 2025. Founders Pledge continues to maintain a multimillion dollar Global Health and Development Fund. EA Funds maintains a Global Health and Development Fund. And lest it be held that no new funds are being developed in this area, the Global Health Funding Circle was launched in Summer 2024.
These efforts will continue to save lives in an effective way for years to come.
5. Conclusion
In this post, we saw that effective altruists were instrumental in the push towards more rigorous and evidence-based methods in global health. Early effective altruists were so dogged in this pursuit that they were criticized for being moralistic and thought to lack empathy.
To date, effective altruists have committed well over a billion dollars to global health causes, and a large amount of funding continues to flow towards global health. Much of that funding continues to be guided by the same commitment to high evidential standards that first animated the effective altruist movement.
We saw that on a very conservative estimate, this work has already saved hundreds of thousands of lives. That’s pretty amazing.
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